女性血清睾酮假性升高案例分析与文献复习  

Case report of pseudoelevated serum testosterone in women and literature review

作　　者：罗薇[1] 侯立安[1] 禹松林[1] 张颖[1] 于佳磊 尹逸丛 刘荔[1] 梁小悦 刘欣[1] 苏玉君[1] 谢少伟[1] 邱玲[1] 夏良裕[1] Luo Wei;Hou Li′an;Yu Songlin;Zhang Ying;Yu Jialei;Yin Yicong;Liu Li;Liang Xiaoyue;Liu Xin;Su Yujun;Xie Shaowei;Qiu Ling;Xia Liangyu(Department of Laboratory Medicine,Peking Union Medical College Hospital,Beijing 100005,China)

机构地区：[1]中国医学科学院,北京协和医院检验科,北京100005

出　　处：《中华检验医学杂志》2022年第12期1275-1278,共4页Chinese Journal of Laboratory Medicine

基　　金：国家重点研发计划(2021YFC2009300/2021YFC2009302);北京市临床重点专科医学检验科卓越项目(ZK201000)。

摘　　要：目的分析女性睾酮测定结果假性升高的病例特点并回顾文献,为临床实验室识别假性睾酮升高提供参考依据。方法回顾性分析北京协和医院3例睾酮假性升高患者的病例特点,比较不同检测平台与方法测定睾酮水平的结果;通过PUBMED、中国知网检索国际和国内与睾酮假性升高、睾酮检测方法相关文献进行综合分析。结果3例女性患者免疫法测定睾酮水平升高,经质谱法测定睾酮水平均正常,排除高雄激素血症诊断。共检索到38篇与睾酮检测相关文献,9篇为假性高雄激素血症的病例报道,其中国内于2021年共有2篇文献报道假性高雄激素血症共12例,所有案例均用液相色谱串联质谱法确认睾酮水平。既往研究明确提示临床实验室常规应用的免疫法测定女性睾酮结果与质谱法相关性差,存在不同程度偏差。结论免疫法检测女性睾酮易受干扰导致结果假性升高,建议临床实验室对所用检测方法进行评估并建立鉴别方案,对于可疑睾酮假性升高的样本采用其他免疫平台或LC-MS/MS法进行确认。Objective The characteristics of women with false elevated testosterone were analyze and the literature was reviewed to provide reference for clinical laboratory identification of false elevated testosterone.Methods The characteristics of three patients with false elevated testosterone in Peking Union Medical College Hospital were analyzed retrospectively,and the results of different detection platforms and methods for the determination of testosterone levels were compared.International and domestic literatures related to false elevation of testosterone and detection methods of testosterone were searched for a comprehensive analysis from PUBMED and CNKI.Results The levels of testosterone in 3 female patients were elevated by immunoassay and normal by mass spectrometry.They were excluded from the diagnosis of hyperandrogenemia.A total of 38 literatures related to testosterone detection were retrieved,of which 9 case reports of pseudohyperandrogenemia,among which 12 cases of pseudohyperandrogenemia were reported in 2 domestic literatures in 2021.All cases were confirmed by liquid chromatography-tandem mass spectrometry(LC-MS/MS).Previous studies have clearly indicated that the result of routine immunoassay in clinical laboratory for the determination of female testosterone have poor correlation with the results of LC-MS/MS,with varying degrees of deviation.Conclusions Immunoassay tests for female testosterone is susceptible to interference and lead to elevated false results.It is suggested that clinical laboratories evaluate the detection methods used and establish a identification program,and confirm samples with suspected pseudoelevated testosterone elevation using other immune platforms or LC-MS/MS.

关 键 词：睾酮 干扰 免疫法 液相色谱串联质谱 高雄激素血症 

分 类 号：R711[医药卫生—妇产科学]