Tate Jill, Ward Greg
Department of Chemical Pathology, Queensland Health Pathology Service, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Clin Biochem Rev. 2004 May;25(2):105-20.
Substances that alter the measurable concentration of the analyte or alter antibody binding can potentially result in immunoassay interference. Interfering, endogenous substances that are natural, polyreactive antibodies or autoantibodies (heterophiles), or human anti-animal antibodies together with other unsuspected binding proteins that are unique to the individual, can interfere with the reaction between analyte and reagent antibodies in immunoassay. Lipaemia, cross-reactivity, and exogenous interferences due to pre-analytical variation, matrix and equipment reaction also affect immunoassay. Interfering substances may lead to falsely elevated or falsely low analyte concentration in one or more assay systems depending on the site of the interference in the reaction and possibly result in discordant results for other analytes. The prevalence of interference is generally low in assays containing blocking agents that neutralise or inhibit the interference but is often higher in new, untested immunoassays. A wide range of analytes measured by immunoassay including hormones, tumour markers, drugs, cardiac troponin and microbial serology may be affected. Interference in immunoassay may lead to the misinterpretation of a patient's results by the laboratory and the wrong course of treatment being given by the physician. Laboratories should put processes in place to detect, test and report suspected interferences. It is equally important that physicians communicate any clinical suspicion of discordance between the clinical and the laboratory data to the laboratory. The detection of interference may require the use of an alternate assay or additional measurements, before and after treatment with additional blocking reagent, or following dilution of the sample in non-immune serum. It is imperative that laboratories inform physicians of the follow-up procedure and report on the presence of any interference. The establishment of on-going laboratory-physician contact is essential to the continuing awareness of wrong patient results due to interference.
改变分析物可测量浓度或改变抗体结合的物质可能会导致免疫测定干扰。干扰性内源性物质，如天然的多反应性抗体或自身抗体（嗜异性抗体），或人抗动物抗体，以及个体特有的其他未被怀疑的结合蛋白，可干扰免疫测定中分析物与试剂抗体之间的反应。脂血、交叉反应以及由于分析前变异、基质和设备反应导致的外源性干扰也会影响免疫测定。干扰物质可能会导致一个或多个测定系统中分析物浓度出现假性升高或假性降低，这取决于反应中干扰的部位，还可能导致其他分析物结果不一致。在含有中和或抑制干扰的封闭剂的测定中，干扰的发生率通常较低，但在新的、未经测试的免疫测定中往往较高。通过免疫测定测量的多种分析物，包括激素、肿瘤标志物、药物、心肌肌钙蛋白和微生物血清学，都可能受到影响。免疫测定中的干扰可能会导致实验室对患者结果的错误解读，以及医生给予错误的治疗方案。实验室应制定检测、测试和报告可疑干扰的流程。同样重要的是，医生应将临床与实验室数据之间任何不一致的临床怀疑告知实验室。干扰的检测可能需要使用替代测定法或进行额外测量，即在使用额外的封闭试剂治疗之前和之后，或在将样品用非免疫血清稀释之后。实验室必须告知医生后续程序，并报告是否存在任何干扰。建立实验室与医生之间的持续联系对于持续了解因干扰导致的患者错误结果至关重要。
