皮质醇测定中血清17-羟孕酮和11-脱氧皮质醇引发的交叉反应。
Cross reactions elicited by serum 17-OH progesterone and 11-desoxycortisol in cortisol assays.
作者信息
Brossaud Julie, Barat Pascal, Gualde Dominique, Corcuff Jean-Benoît
机构信息
Department of Nuclear Medicine, University Hospital and University of Bordeaux, France.
出版信息
Clin Chim Acta. 2009 Sep;407(1-2):72-4. doi: 10.1016/j.cca.2009.05.019. Epub 2009 May 28.
BACKGROUND
Different pathophysiological situations such as congenital adrenal hyperplasia, adrenocortical carcinoma, metyrapone treatment, etc. elicit specificity problems with serum cortisol assay.
METHODS
We assayed cortisol using 2 kits and performed cross reaction studies as well as multiple regression analysis using 2 other steroids: 11-desoxycortisol and 17-OH progesterone.
RESULTS
Analysis showed the existence of an analytical bias. Importantly, significantly different biases were demonstrated in newborns or patients taking metyrapone. Multiple regression analysis and cross reaction studies showed that 11-desoxycortisol level significantly influenced cortisol determination. Moreover, despite using the normal ranges provided by manufacturers discrepant results occurred such as 17% discordance in the diagnosis of hypocorticism in infants.
CONCLUSION
We wish to raise awareness about the consequences of the (lack of) specificity of cortisol assays with regard to the evaluation of hypocorticism in infants or when "unusual" steroids may be increased.
背景
不同的病理生理情况，如先天性肾上腺皮质增生、肾上腺皮质癌、甲吡酮治疗等，会引发血清皮质醇检测的特异性问题。
方法
我们使用2种试剂盒检测皮质醇，并使用另外2种类固醇：11-脱氧皮质醇和17-羟孕酮进行交叉反应研究以及多元回归分析。
结果
分析显示存在分析偏差。重要的是，在新生儿或服用甲吡酮的患者中表现出显著不同的偏差。多元回归分析和交叉反应研究表明，11-脱氧皮质醇水平对皮质醇测定有显著影响。此外，尽管使用了制造商提供的正常范围，但仍出现了不一致的结果，如婴儿肾上腺皮质功能减退诊断中的17%不一致率。
结论
我们希望提高人们对皮质醇检测（缺乏）特异性在评估婴儿肾上腺皮质功能减退或“异常”类固醇可能升高时所产生后果的认识。
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