Schaadt B, Feldt-Rasmussen U, Rasmusson B, Tørring H, Foder B, Jørgensen K, Hansen H S
Department of Oncology, Herlev University Hospital, Denmark.
Thyroid. 1995 Jun;5(3):165-70. doi: 10.1089/thy.1995.5.165.
The purpose of the study was to examine the value of a commercial immunoradiometric (IRMA) method for measuring serum thyroglobulin as a tumor marker after treatment for differentiated thyroid carcinoma. A prospective analysis of consecutive serum samples from 53 patients was performed using the IRMA method and a traditional double antibody radioimmunoassay (RIA). The results were compared with those of 100 healthy control subjects and furthermore the method was validated by investigating sera from 24 patients with Hashimoto's thyroiditis positive for thyroglobulin autoantibodies. Finally, in vitro studies of the influence of thyroglobulin autoantibodies on the method were done. The IRMA method had an acceptable analytical precision and was more sensitive than the RIA. It was furthermore less sensitive to the presence of thyroglobulin autoantibodies but it was affected by them, and it showed less unspecific serum effect. Both methods had limitations as tumor marker when the patients had a thyroid remnant, when serum thyrotropin was not suppressed, and in cases of local recurrence. The highest predictive value was found in patients with distant metastases. Thus, in cases of only slightly elevated serum thyroglobulin, the strongest indication for recurrence is still an increasing serum thyroglobulin level within the same patient rather than a single value.
本研究的目的是检测一种商业化免疫放射分析（IRMA）方法在分化型甲状腺癌治疗后测量血清甲状腺球蛋白作为肿瘤标志物的价值。使用IRMA方法和传统双抗体放射免疫分析（RIA）对53例患者的连续血清样本进行前瞻性分析。将结果与100名健康对照者的结果进行比较，此外，通过检测24例甲状腺球蛋白自身抗体阳性的桥本甲状腺炎患者的血清来验证该方法。最后，对甲状腺球蛋白自身抗体对该方法的影响进行了体外研究。IRMA方法具有可接受的分析精密度，且比RIA更灵敏。此外，它对甲状腺球蛋白自身抗体的存在不太敏感，但会受到其影响，并且显示出较少的非特异性血清效应。当患者有甲状腺残留、血清促甲状腺素未被抑制以及局部复发时，两种方法作为肿瘤标志物均有局限性。在远处转移患者中发现了最高的预测价值。因此，在血清甲状腺球蛋白仅略有升高的情况下，复发的最强指征仍然是同一患者血清甲状腺球蛋白水平的升高，而不是单个值。
