Cheng Xinqi, Guo Xiuzhi, Chai Xiaofeng, Hu Yingying, Lian Xiaolan, Zhang Guojun
Department of Clinical Diagnosis, Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
Departments of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Clin Chim Acta. 2021 Jan;512:63-65. doi: 10.1016/j.cca.2020.11.018. Epub 2020 Dec 5.
Interference due to the presence of heterophilic antibodies may lead to falsely low or high analyte concentrations, but falsely elevated values are more common in most immunoassay platforms. We report a case of a 53-y old female patient underwent radical thyroidectomy for thyroid papillary carcinoma and the results of TSH in the Siemens Advia Centaur XP after surgery were not suppressed, ranging from 5.73 and 6.61 μIU/ml.
The status of the thyroid was then assessed using 4 assay platforms from Siemens, Abbott, Roche and Beckman.
The results of TSH were 5.52, 0.54, 0.12, and <0.015 μIU/ml, respectively. After the samples were pretreated with the heterophilic antibody blocker, results given by Siemens, Abbott, and Roche showed significant decreases of 0.003, 0.001, and 0.005 μIU/ml, respectively. Therefore, it was confirmed that the presence of heterophilic antibodies in the patient samples interfered with the TSH measurements in multiple assay systems.
Clinicians must be aware of the possible assay interference, including the measurements of FT4, FT3 and TSH, results may be misleading in the presence of heterophilic antibodies, in particular when the results of thyroid function tests do not fit the patient clinical presentation.
嗜异性抗体的存在所导致的干扰可能会使分析物浓度出现假性降低或升高，但在大多数免疫分析平台中，假性升高的值更为常见。我们报告一例53岁女性患者，因甲状腺乳头状癌接受了根治性甲状腺切除术，术后西门子Advia Centaur XP检测的促甲状腺激素（TSH）结果未被抑制，范围在5.73至6.61 μIU/ml之间。
随后使用西门子、雅培、罗氏和贝克曼的4种检测平台评估甲状腺状态。
TSH结果分别为5.52、0.54、0.12和<0.015 μIU/ml。在用嗜异性抗体阻断剂对样本进行预处理后，西门子、雅培和罗氏给出的结果分别显著下降了0.003、0.001和0.005 μIU/ml。因此，证实了患者样本中嗜异性抗体的存在干扰了多种检测系统中的TSH测量。
临床医生必须意识到可能存在的检测干扰，包括游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）和TSH的测量，在存在嗜异性抗体时结果可能会产生误导，尤其是当甲状腺功能测试结果与患者临床表现不符时。
