Estrada Joshua M, Soldin Danielle, Buckey Timothy M, Burman Kenneth D, Soldin Offie P
1 Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center , Washington, District of Columbia.
Thyroid. 2014 Mar;24(3):411-23. doi: 10.1089/thy.2013.0119. Epub 2013 Dec 13.
Serum thyrotropin (TSH) is considered the single most sensitive and specific measure of thyroid function in the general population owing to its negative logarithmic association with free triiodothyronine and free thyroxine concentrations. It is therefore often the test of choice for screening, diagnosis, and monitoring of primary hypothyroidism. Serum TSH concentrations can be analyzed quantitatively using third-generation immunoassays, whereas its bioactivity can be measured by TSH activity assays in cell culture. Theoretically, if serum TSH concentrations are directly related to TSH activity, the two tests should yield comparable results. However, on occasion, the results are discordant, with serum concentrations being higher than TSH biological activity. This review focuses on the dissociation between the clinical state and serum TSH concentrations and addresses clinically important aspects of TSH analysis.
血清促甲状腺激素（TSH）被认为是普通人群甲状腺功能最敏感且特异的单一指标，因为它与游离三碘甲状腺原氨酸和游离甲状腺素浓度呈负对数关联。因此，它常常是原发性甲状腺功能减退症筛查、诊断及监测的首选检测项目。血清TSH浓度可使用第三代免疫分析法进行定量分析，而其生物活性可通过细胞培养中的TSH活性测定法来测量。理论上，如果血清TSH浓度与TSH活性直接相关，那么这两种检测方法应得出可比的结果。然而，有时结果并不一致，血清浓度高于TSH生物活性。本综述聚焦于临床状态与血清TSH浓度之间的解离现象，并探讨TSH分析在临床上的重要方面。
