Bourrel F, Hoff M, Regis H, Courrière P, Caron P
Department of Nuclear Medicine, CHU, Toulouse, France.
Clin Chem Lab Med. 1998 Sep;36(9):725-30. doi: 10.1515/CCLM.1998.128.
As interference from thyroglobulin autoantibodies appears to have been overcome in new commercial thyroglobulin assays by the use of monoclonal antibodies, the need for thyroglobulin recovery tests became uncertain. Sera (n=45) from patients with differentiated thyroid carcinomas were selected on the basis of a thyroglobulin recovery value below 70% in the Dynotest Tg immunoradiometric assay (Brahms) routinely used in our laboratory. Serum thyroglobulin levels were then measured using three other commercial immunoradiometric assays: thyroglobulin ERIA (Pasteur), HTGK (Sorin) and ELSA HTG (Cis Bio International). Thyroglobulin autoantibodies were measured using the Thyrak assay (Brahms). Although many patients were thyroglobulin antibodies-negative (< 200 U/ml, n=26), most immunoradiometric assays failed to detect thyroglobulin in patients with evidence of recurrence. Low thyroglobulin values associated with low thyroglobulin recovery in thyroglobulin antibody-negative patients appear to be more biologically relevant than a single low thyroglobulin value, which can lead to lack of medical intervention. We conclude that the thyroglobulin recovery test is a prerequisite for the correct interpretation of serum thyroglobulin levels determined with immunoradiometric assays in the follow-up of thyroglobulin autoantibody-negative patients treated for differentiated thyroid carcinomas.
由于新型商业化甲状腺球蛋白检测方法通过使用单克隆抗体似乎已克服了甲状腺球蛋白自身抗体的干扰，甲状腺球蛋白回收率检测的必要性变得不确定。根据我们实验室常规使用的Dynotest Tg免疫放射分析（勃林格殷格翰公司）中甲状腺球蛋白回收率低于70%的标准，从分化型甲状腺癌患者中选取了45份血清样本。然后使用其他三种商业化免疫放射分析方法检测血清甲状腺球蛋白水平：甲状腺球蛋白酶免疫放射分析（巴斯德公司）、HTGK（索林集团）和ELSA HTG（希思生物国际公司）。使用Thyrak检测方法（勃林格殷格翰公司）检测甲状腺球蛋白自身抗体。尽管许多患者甲状腺球蛋白抗体呈阴性（<200 U/ml，n = 26），但大多数免疫放射分析方法未能在有复发迹象的患者中检测到甲状腺球蛋白。在甲状腺球蛋白抗体阴性的患者中，与低甲状腺球蛋白回收率相关的低甲状腺球蛋白值似乎比单一的低甲状腺球蛋白值在生物学上更具相关性，单一低甲状腺球蛋白值可能导致缺乏医疗干预。我们得出结论，对于接受分化型甲状腺癌治疗的甲状腺球蛋白自身抗体阴性患者的随访，甲状腺球蛋白回收率检测是正确解读免疫放射分析测定的血清甲状腺球蛋白水平的先决条件。
