Elecsys 2010检测到的大分子催乳素的患病率。

Prevalence of macroprolactin detected by Elecsys 2010.

作者信息

Sánchez-Eixerés M R, Mauri M, Alfayate R, Graells M L, Miralles C, López A, Picó A

机构信息

Hormone Laboratory, Hospital General Universitario de Alicante, Spain.

出版信息

Horm Res. 2001;56(3-4):87-92. doi: 10.1159/000048097.

DOI:10.1159/000048097

PMID:11847468

Abstract

BACKGROUND

Macroprolactin or big-big PRL is, usually, a complex of little prolactin (PRL) with anti-PRL autoantibody. There are some patients with hyperprolactinemia showing a high proportion of serum macroprolactin. However, its clinical significance is not clear. Immunoassays used to determine PRL differ in their ability to detect macroprolactin. Moreover, in recent years, PRL assays have changed from isotopic methods (radioimmunoassays and immunoradiometric assays) to non-isotopic automated immunoassays. The effect of macroprolactin on currently used methods is often unknown. The aim of this work was to study the different reactivity of macroprolactin in two immunoassays systems, Elecsys 2010 and ACS Centaur, and to assess the clinical repercussion of this condition.

METHODS

We studied retrospectively 956 consecutive routine patients. Samples with a PRL value >636 mIU/l (211 samples) were subjected to the polyethylene glycol (PEG) precipitation test to detect macroprolactin, and 2 of them also to gel filtration chromatography for further confirmation. PRL was measured by Elecsys 2010 and, alternatively, by ACS Centaur.

RESULTS

By Elecsys 2010, macroprolactin was detected in 19 patients (9%). After removing macroprolactin, PRL levels were within the normal range in every case but one. When original sera from patients with macroprolactin were processed with ACS Centaur. PRL levels were normal or only marginally elevated. The correlation of PRL values in samples with and without macroprolactin assayed by both systems was 0.64 and 0.98, respectively.

CONCLUSIONS

Nearly 9% of hyperprolactinemic patients detected by Elecsys 2010 may have macroprolactin, but the detection rate obtained using ACS Centaur is much lower. As macroprolactin seems to have minimal clinical relevance, it would be important that the users of PRL assays be aware to what extent macroprolactin interferes with their assays, and have available a validated method, such as the PEG precipitation test, to confirm the presence of macroprolactin.

摘要

背景

巨泌乳素或大 - 大泌乳素通常是小分子泌乳素（PRL）与抗PRL自身抗体的复合物。有一些高泌乳素血症患者血清中巨泌乳素比例较高。然而，其临床意义尚不清楚。用于测定PRL的免疫测定法在检测巨泌乳素的能力上存在差异。此外，近年来，PRL检测已从同位素方法（放射免疫测定法和免疫放射ometric测定法）转变为非同位素自动化免疫测定法。巨泌乳素对当前使用方法的影响通常未知。这项工作的目的是研究巨泌乳素在两种免疫测定系统（Elecsys 2010和ACS Centaur）中的不同反应性，并评估这种情况的临床影响。

方法

我们回顾性研究了956例连续的常规患者。PRL值>636 mIU/l的样本（211个样本）进行聚乙二醇（PEG）沉淀试验以检测巨泌乳素，其中2个样本还进行凝胶过滤色谱法进一步确认。PRL通过Elecsys 2010测定，或者通过ACS Centaur测定。

结果

通过Elecsys 2010检测到19例患者（9%）存在巨泌乳素。去除巨泌乳素后，除1例患者外，其他患者的PRL水平均在正常范围内。当用ACS Centaur处理含有巨泌乳素患者的原始血清时，PRL水平正常或仅略有升高。两种系统测定的有巨泌乳素和无巨泌乳素样本中PRL值的相关性分别为0.64和0.98。