血清催乳素高估与误诊风险。
Serum prolactin overestimation and risk of misdiagnosis.
作者信息
De Sousa Sunita M C, Saleem Mohamed, Rankin Wayne, Torpy David J
机构信息
Endocrine and Metabolic Unit Royal Adelaide Hospital Adelaide South Australia Australia.
Department of Genetics and Molecular Pathology, Centre for Cancer Biology an SA Pathology and University of South Australia Alliance Adelaide South Australia Australia.
出版信息
Endocrinol Diabetes Metab. 2019 Mar 23;2(3):e00065. doi: 10.1002/edm2.65. eCollection 2019 Jul.
BACKGROUND
Falsely elevated prolactin measurements risk overdiagnosis, and unnecessary imaging and treatment.
DESIGN
We conducted a clinical audit of 18 patients who presented with hyperprolactinaemia, followed by a laboratory audit of 40 split samples across a range of serum prolactin (5-5051 mIU/L). In each case (total n = 58), serum prolactin was measured on both Roche and Siemens platforms.
RESULTS
Serum prolactin as measured by Roche was higher than the corresponding Siemens value in every case, despite similar reference ranges. The mean discrepancy in serum prolactin by Roche vs. Siemens was +81% in the clinical audit and +50% in the laboratory audit. This led to unnecessary interventions in 7/18 patients (39%) in the clinical audit.
CONCLUSIONS
Serum prolactin is overestimated on the Roche relative to the Siemens platform. Laboratories should review Roche reference intervals for serum prolactin, and clinicians should consider repeating serum prolactin on another platform if the serum prolactin is incongruent with the clinical scenario.
背景
催乳素测量值假性升高有过度诊断以及进行不必要的影像学检查和治疗的风险。
设计
我们对18例高催乳素血症患者进行了临床审核，随后对一系列血清催乳素水平（5 - 5051 mIU/L）的40份分装样本进行了实验室审核。在每种情况下（共计n = 58），均在罗氏和西门子平台上测量血清催乳素。
结果
尽管参考范围相似，但罗氏测定的血清催乳素在每种情况下均高于相应的西门子测定值。在临床审核中，罗氏与西门子测定的血清催乳素平均差异为 +81%，在实验室审核中为 +50%。这导致临床审核中的7/18例患者（39%）接受了不必要的干预。
结论
相对于西门子平台，罗氏平台高估了血清催乳素水平。实验室应重新审视罗氏血清催乳素参考区间，并且如果血清催乳素水平与临床情况不符，临床医生应考虑在另一个平台上重复检测血清催乳素。
Zotero 插件