Department of Laboratory Medicine, Peking Union Medical College Hospital, CAMS, Beijing, China.
Department of Hematology, Peking Union Medical College Hospital, CAMS, Beijing, China.
J Clin Lab Anal. 2020 Aug;34(8):e23342. doi: 10.1002/jcla.23342. Epub 2020 Apr 22.
Soluble transferrin receptor (sTfR) is a promising indicator of iron deficiency anemia (IDA). Here, we investigated the application value of sTfR assays based on three different methods for the diagnosis of IDA.
The sTfR concentrations in two groups of patient specimens with high-level and low-level sTfR concentrations and in quality control materials were measured four times a day for five consecutive days to evaluate the precision of the three methods. We selected patients with IDA, anemia of chronic disease (ACD), or chronic diseases with iron deficiency anemia (CIDA), and apparently healthy subjects, and measured the serum sTfR concentrations in all subjects using the three different methods. The cutoff points for an IDA diagnosis using the three assays and their corresponding clinical sensitivities and specificities were calculated by receiver operating characteristic analysis.
For the diagnosis of IDA, the cutoff points of sTfR measured by the chemiluminescent, immunoturbidimetric, and immunonephelometric assays were 2.91, 6.70, and 2.48 mg/L, respectively. The corresponding sensitivities were 85.59%, 85.59%, and 85.59%, the specificities were 91.47%, 90.31%, and 90.70%, and area under the curve was 0.943, 0.944, and 0.936, respectively. The sTfR concentrations measured by the different methods were significantly higher in the IDA and CIDA groups than in the other two groups (P < .05).
The sTfR based on the three different measurement methods presented promising analytical performances and met the clinical requirements for sensitivity and specificity. However, the different measurement methods had markedly different cutoff points for IDA diagnosis, which should be critically considered in clinical practice.
可溶性转铁蛋白受体（sTfR）是缺铁性贫血（IDA）有前途的指标。在这里，我们研究了基于三种不同方法的 sTfR 测定在 IDA 诊断中的应用价值。
每天四次测量两组高浓度和低浓度 sTfR 浓度的患者标本以及质控材料的 sTfR 浓度，连续五天以评估三种方法的精密度。我们选择 IDA、慢性病贫血（ACD）或慢性病合并缺铁性贫血（CIDA）患者和明显健康的受试者，并使用三种不同的方法测量所有受试者的血清 sTfR 浓度。通过接收者操作特征分析计算三种检测方法的 IDA 诊断切点及其相应的临床灵敏度和特异性。
对于 IDA 的诊断，化学发光法、免疫比浊法和免疫散射比浊法测定的 sTfR 切点分别为 2.91、6.70 和 2.48mg/L。相应的灵敏度分别为 85.59%、85.59%和 85.59%，特异性分别为 91.47%、90.31%和 90.70%，曲线下面积分别为 0.943、0.944 和 0.936。IDA 和 CIDA 组的 sTfR 浓度明显高于其他两组（P<.05）。
基于三种不同测量方法的 sTfR 呈现出有前途的分析性能，满足灵敏度和特异性的临床要求。然而，不同的测量方法对 IDA 诊断的切点明显不同，在临床实践中应仔细考虑。
