何健 潘明志  黄蕤  唐恭顺

[摘要] 目的 探讨不同浓度的抗甲状腺球蛋白抗体（TgAb）对甲状腺球蛋白（Tg）测量值的干扰。 方法 通过混合Tg和TgAb标准品，混合患者的血清高Tg低TgAb和高TgAb低Tg产生实验样本，用放射免疫法测量Tg。比较混合前后Tg浓度值。 结果 Ⅰ组试验样本的变异系数为（4.21±3.51）% （0～14.82） （r=0.998）；Ⅱ组试验样本的变异系数为（2.83±2.23）% （0.87～11.21） （r=0.999）；Ⅰ组样本中，增加TgAb浓度，Tg的测量值呈比例下降，呈明显的直线负相关趋势（P均＜0.01）；Ⅱ组样本中，随着TgAb浓度增高，Tg的测量值呈比例下降，呈明显的直线负相关趋势（P均＜0.05）。 结论 血清TgAb浓度过高，Tg的测定值显著会低于实际Tg浓度值，且TgAb的浓度越高，对Tg分析产生的干扰越大。所以临床工作中，分析血清Tg测定值，需要结合血清TgAb测定值。

[关键词] 甲状腺球蛋白；甲状腺球蛋白抗体；分化型甲状腺癌；放射免疫法

[中图分类号] R736.1   [文献标识码] A   [文章编号] 2095-0616（2014）08-07-04

Study of influence of different TgAb concentrations on radioimmunoassay measurement of serum Tg concentrations

HE Jian1,2  PAN Mingzhi2  HUANG Rui2  TANG Gongshun2

1.Department of Nuclear Medicine,Chengdu Second People's Hospital,Chengdu 610017,China;2.Department of Nuclear Medicine,West China Hospital of Sichuan University,Chengdu 610041,China

[Abstract] Objective To evaluate the interference of different concentrations of anti-thyroglobulin antibodies (TgAb) on the measurement values of thyroglobulin (Tg). Methods Through blending Tg and TgAb standards,the patients'serum high Tg and low TgAb and high TgAb and low Tg were blended to produce experimental samples. The radioimmunoassay was used to measure Tg.The Tg concentration values before and after blending were compared. Results The variation coefficient of the experiment samples in group I was (4.21±3.51)% (0-14.82) (r=0.998);The variation coefficient of the experiment samples in group Ⅱ was (2.83±2.23)% (0.87-11.21)(r=0.999).In the samples of group I,when increasing the TgAb concentration,the Ig measurement value dropped proportionally, presenting a significant linear negative correlation trend (P＜0.01 for all);In the samples of group Ⅱ,as the TgAb concentration increased,the Ig measurement value dropped proportionally,presenting a significant linear negative correlation trend (P＜0.05 for all). Conclusion When the serum TgAb concentration is excessively high,the measurement value of Tg is significantly lower than the actual Tg concentration value, and the higher the TgAb concentration is, the larger the interference produced by Tg is.Therefore,in clinical work,analysis of serum Tg measurement value should combine serum TgAb measurement value.

[Key words] Thyroglobulin;Thyroglobulin antibodies;Differentiated thyroid cancer; Radioimmunoassay

血清甲状腺球蛋白（thyroglobulin，Tg）是甲状腺滤泡上皮细胞合成的一种二聚体糖蛋白，贮存在细胞或者滤泡腔内，以胶体形式在细胞和腺腔内循环，仅微量Tg进入血液循环内。分化型甲状腺癌（differentiated thyroid cancer，DTC）患者经手术切除和131I清甲治疗后，血清Tg应小于1ng/mL或者检测不到，如血清Tg水平升高，提示有可能存在DTC临床复发或转移。因此，准确检测血清Tg浓度是判断分化型甲状腺癌（DTC）患者有无复发和转移的一种特异性高的检查方法[1-3]。血清Tg刺激产生甲状腺球蛋白抗体（thyroglobulin antibody，TgAb），由于TgAb的存在，干扰了血清Tg的测量[4]。当TgAb存在时，测量TSH刺激状态的Tg浓度，将导致评判甲状腺癌复发或转移的失败。有人认为TgAb对Tg影响的大小与TgAb浓度有关[5]。……