Parlant-Pinet Lucile, Harthé Catherine, Roucher Florence, Morel Yves, Borson-Chazot Françoise, Raverot Gérald, Raverot Véronique
Faculté de Médecine Lyon-EstUniversité Claude Bernard Lyon 1, Lyon, FranceHospices Civils de LyonLaboratoire d'Hormonologie, Centre de Biologie et de Pathologie EstHospices Civils de LyonFédération d'endocrinologie, Groupement Hospitalier Est, 59 bd Pinel, F-69677 Bron Cedex, France.
Faculté de Médecine Lyon-EstUniversité Claude Bernard Lyon 1, Lyon, FranceHospices Civils de LyonLaboratoire d'Hormonologie, Centre de Biologie et de Pathologie EstHospices Civils de LyonFédération d'endocrinologie, Groupement Hospitalier Est, 59 bd Pinel, F-69677 Bron Cedex, France Faculté de Médecine Lyon-EstUniversité Claude Bernard Lyon 1, Lyon, FranceHospices Civils de LyonLaboratoire d'Hormonologie, Centre de Biologie et de Pathologie EstHospices Civils de LyonFédération d'endocrinologie, Groupement Hospitalier Est, 59 bd Pinel, F-69677 Bron Cedex, France.
Eur J Endocrinol. 2015 Jun;172(6):687-95. doi: 10.1530/EJE-14-1073. Epub 2015 Mar 9.
Gel filtration chromatography (GFC), the gold standard for macroprolactinaemia (MPRL) diagnosis, is a slow, costly and labour-intensive method. To limit the number of GFC required, we evaluated two screening tests for MPRL: prolactin (PRL) recovery after polyethylene glycol (PEG) precipitation and PRL concentration ratio, derived from two assays, each having different big-big-PRL cross-reactivities.In some patients, MPRL is characterised by clinical symptoms which can be associated with an excess of monomeric PRL. We compared the monomeric PRL concentration obtained from GFC with the PRL concentration i) on a cobas e 601 analyser and ii) in the supernatant after PEG precipitation.
We studied hyperprolactinaemic sera subjected to physician-ordered GFC, between February 2013 and July 2014. We performed PEG precipitation (to evaluate the PRL concentration and rate of recovery in the supernatant) and two PRL assays: RIA and electrochemiluminescent assay (ECLIA), on a Roche cobas e 601 analyser, and calculated the RIA/ECLIA ratio.
Among the 222 sera, we were able to diagnose or exclude MPRL in 72.1% of cases, based solely on the ratio and/or recovery. In the remaining cases, GFC was necessary for making a diagnosis. Elevated monomeric PRL was present in 10.9% of macroprolactinaemic sera. In the case of MPRL, both PRL measurements on the cobas analyser and in the supernatant weakly correlated with monomeric PRL values obtained from GFC.
The combination of PEG and RIA/ECLIA ratio analysis reduced the number of necessary GFC. However, GFC is essential in MPRL cases to evaluate the monomeric PRL concentration.
凝胶过滤色谱法（GFC）是诊断巨泌乳素血症（MPRL）的金标准，但该方法速度慢、成本高且劳动强度大。为了减少所需的GFC检测次数，我们评估了两种MPRL筛查试验：聚乙二醇（PEG）沉淀后泌乳素（PRL）回收率以及PRL浓度比，后者源自两种具有不同大-大-PRL交叉反应性的检测方法。在一些患者中，MPRL的特征是临床症状，可能与单体PRL过量有关。我们将GFC获得的单体PRL浓度与PRL浓度进行了比较，i）在cobas e 601分析仪上检测的浓度，ii）PEG沉淀后的上清液中的浓度。
我们研究了2013年2月至2014年7月期间接受医嘱GFC检测的高泌乳素血症血清。我们进行了PEG沉淀（以评估上清液中的PRL浓度和回收率）以及两种PRL检测：放射免疫分析（RIA）和电化学发光分析（ECLIA），在罗氏cobas e 601分析仪上进行，并计算RIA/ECLIA比值。
在222份血清中，仅基于该比值和/或回收率，我们能够在72.1%的病例中诊断或排除MPRL。在其余病例中，需要GFC来进行诊断。10.9%的巨泌乳素血症血清中存在升高的单体PRL。在MPRL病例中，cobas分析仪上和上清液中的PRL测量值与GFC获得的单体PRL值均呈弱相关。
PEG与RIA/ECLIA比值分析相结合减少了所需GFC检测的次数。然而，在MPRL病例中，GFC对于评估单体PRL浓度至关重要。
