Dekker Bernadette L, van der Horst-Schrivers Anouk N A, Brouwers Adrienne H, Shuford Christopher M, Kema Ido P, Muller Kobold Anneke C, Links Thera P
Internal Medicine, Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Department of Emergency Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
Eur Thyroid J. 2022 Oct 20;11(6). doi: 10.1530/ETJ-22-0137. Print 2022 Dec 1.
Thyroglobulin (Tg) is an established tumor marker for differentiated thyroid carcinoma (DTC) patients. However, Tg immunoassays can be subject to Tg autoantibody (TgAb) interference resulting in incorrect Tg values. Therefore, Tg measurement with liquid chromatography-tandem mass spectrometry (LC-MS/MS) could be promising in patients with TgAbs. In this study, we compared Tg IRMA and Tg-LC-MS/MS analytically in the presence of TgAbs. Furthermore, we compared the clinical interpretation of results obtained by both Tg assays in DTC patients with lower TgAbs titers (<10 U/mL) during 131I ablation therapy.
Totally 118 DTC patients diagnosed between 2006 and 2014 in a University Medical Center were followed with the Tg-IRMA (Thermo Fischer Scientific) and ARCHITECT anti-Tg (Abbott Laboratories) assays. We re-analyzed their samples with a sensitive Tg-LC-MS/MS method (Labcorp, limit of quantification of 0.02 ng/mL). Passing-Bablok regression analysis was performed on samples obtained during 131I ablation therapy and follow-up.
In 304 samples with lower TgAb titers, a good analytical agreement was found between both Tg assays (slope of 1.09 (95% CI: 1.05-1.16)). Fifty-five samples with potentially interfering TgAbs showed higher Tg-LC-MS/MS values than Tg-IRMA (slope of 1.45 (95% CI: 1.12->>100)). In patients(n = 91) with lower TgAb titers at the time of 131I ablation therapy, the Tg assays showed a clinical concordance of 91.2, 87.9, and 98.9%, respectively, using a Tg cut-off value of 1.0, 2.0, and 5.0 ng/mL.
In DTC patients with lower titer TgAbs, Tg-IRMA is still a reliable and useful tumor marker. In DTC patients with potentially interfering TgAbs, Tg-IRMA values decreased due to TgAb interference.
甲状腺球蛋白(Tg)是分化型甲状腺癌(DTC)患者公认的肿瘤标志物。然而,Tg免疫测定可能受到Tg自身抗体(TgAb)干扰,导致Tg值不准确。因此,对于存在TgAb的患者,采用液相色谱-串联质谱法(LC-MS/MS)测定Tg可能很有前景。在本研究中,我们在存在TgAb的情况下对Tg免疫放射分析(IRMA)和Tg-LC-MS/MS进行了分析比较。此外,我们还比较了在131I消融治疗期间TgAb滴度较低(<10 U/mL)的DTC患者中两种Tg检测方法所得结果的临床解读。
对2006年至2014年期间在某大学医学中心确诊的118例DTC患者采用Tg-IRMA(赛默飞世尔科技公司)和ARCHITECT抗Tg(雅培实验室)检测方法进行随访。我们采用灵敏的Tg-LC-MS/MS方法(Labcorp,定量限为0.02 ng/mL)对他们的样本进行重新分析。对131I消融治疗及随访期间获得的样本进行Passing-Bablok回归分析。
在304份TgAb滴度较低的样本中,两种Tg检测方法之间具有良好的分析一致性(斜率为1.09(95%CI:1.05-1.16))。55份存在潜在干扰性TgAb的样本显示,Tg-LC-MS/MS值高于Tg-IRMA(斜率为1.45(95%CI:1.12->>100))。在131I消融治疗时TgAb滴度较低的患者(n = 91)中,当Tg临界值分别为1.0、2.0和5.0 ng/mL时,两种Tg检测方法的临床一致性分别为91.2%、87.9%和98.9%。
在TgAb滴度较低的DTC患者中,Tg-IRMA仍然是一种可靠且有用的肿瘤标志物。在存在潜在干扰性TgAb的DTC患者中,由于TgAb干扰,Tg-IRMA值降低。