Centro de Doenças da Tireoide e Laboratório de Endocrinologia Molecular e Translacional, Divisão de Endocrinologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Grupo Fleury, São Paulo, SP, Brasil.
Arch Endocrinol Metab. 2024 Mar 7;68:e230115. doi: 10.20945/2359-4292-2023-0115.
Thyroglobulin (Tg) levels are important to predict recurrence in differentiated thyroid cancer patients.However, false-positive results can hence the request of unnecessary tests and treatments. We reported two cases of interference in thyroglobulin measurement and the workup to investigate them. Both patients achieved an excellent response to therapy after total thyroidectomy and one patient had also received radioiodine treatment. During the follow-up, Tg levels increased and there was no evidence of recurrent disease in the imaging studies. The Tg levels by the Access platform were positive but the results by Elecsys platform and LC-MS/MS were undetectable, leading to the hypothesis of heterophile antibodies (HAbs) interference. The possibility of HAbs interference must be considered when the Tg levels do not fit in the clinical picture. The measurement of Tg by another immunoassay or by LC-MS/MS may be useful in these situations.
甲状腺球蛋白（Tg）水平对于预测分化型甲状腺癌患者的复发很重要。然而，假阳性结果可能导致不必要的检查和治疗。我们报告了两例甲状腺球蛋白测定干扰的病例，并对其进行了检查。这两名患者在全甲状腺切除术后均获得了良好的治疗反应，其中一名患者还接受了放射性碘治疗。在随访期间，Tg 水平升高，影像学检查未见疾病复发。Access 平台的 Tg 水平呈阳性，但 Elecsys 平台和 LC-MS/MS 的结果不可检测，这导致了异嗜性抗体（HAbs）干扰的假说。当 Tg 水平与临床表现不相符时，必须考虑 HAbs 干扰的可能性。在这种情况下，通过另一种免疫分析法或 LC-MS/MS 测量 Tg 可能会有所帮助。
