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Evaluation of the BRAHMS Kryptor® Thyroglobulin Minirecovery Test in patients with differentiated thyroid carcinoma

  • Luca Giovanella EMAIL logo , Mauro Imperiali , Frederik A. Verburg and Luca Ceriani
Published/Copyright: August 19, 2012

Abstract

Background: The present study was undertaken to evaluate a new sensitive thyroglobulin (Tg) mini-recovery test (Tg-mrec) for the detection of potential interferences in sera from patients with differentiated thyroid carcinoma (DTC) and low Tg levels.

Methods: 167 DTC patients with serum Tg <2 μg/L were enrolled. Both TgAb and Tg-mrec measurements were performed on the automated Kryptor® platform. Serum pretreatment in proprietory blocking tubes was perfomed to screen for heterophile antibody interferences. The concordance rates between tests were evaluated.

Results: One case of over-recovery occurred in a patient with discordant Tg results in different immunoassays. The prevalences of a positive TgAb test and a reduced recovery rate were 15%–12%, respectively. Serum TgAb and Tg-mrec tests were both positive in 16 patients, both negative in 138 patients and discordant in 13 patients, respectively. The concordance rate between the Tg-mrec test and the TgAb assay was 92% (Cohens’ kappa 0.894; 95% confidence interval: 0.82–0.93, p<0.001). In all, among seven clinically relevant interferences, three were found by TgAb, five by Tg-mrec and six by using both tests.

Conclusions: The automated Kryptor® Tg-mrec test has a complimentary value to TgAb immunoassay testing in the detection of potential interferences in Tg measurements in patients with DTC and low Tg values (i.e., <2 μg/L). Tg-mrec may detect interferences from TgAb not measured directly by an individual TgAb assay or from other interfering substances, such as heterophile antibodies.


Corresponding author: Luca Giovanella, Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Via Ospedale 12, CH-6500 Bellinzona, Switzerland, Phone: +41-91-811 86 72, Fax: +41-91-811 82 50

References

1. Grebe SK. Diagnosis and management of thyroid carcinoma: focus on serum thyroglobulin. Expert Rev Endocrinol Metab 2009;4:25–43.10.1586/17446651.4.1.25Search in Google Scholar

2. Giovanella L. Highly sensitive thyroglobulin measurements in differentiated thyroid carcinoma management. Clin Chem Lab Med 2008;46:1067–73.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000259147200002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

3. Spencer C. Challenges of serum thyroglobulin (Tg) measurement in the presence of Tg autoantibodies. J Clin Endocrinol Metab 2004;89:3702–4.10.1210/jc.2004-0986Search in Google Scholar PubMed

4. Clark P, Franklyn J. Can we interpret serum thyroglobulin results? Ann Clin Biochem 2012;49:313–22.10.1258/acb.2011.011248http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000307798900001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

5. Mariotti S, Barbesino G, Caturegli P, Marinó M, Manetti L, Pacini F, et al. Assay of thyroglobulin in serum with thyroglobulin autoantibodies: an unobtainable goal? J Clin Endocrinol Metab 1995;80:468–72.10.1210/jc.80.2.468Search in Google Scholar PubMed

6. Feldt-Rasmussen U, Rasmussen AK. Serum thyroglobulin (Tg) in presence of thyroglobulin autoantibodies (TgAb). Clinical and methodological relevance of the interaction between Tg and TgAb in vitro and in vivo. J Endocrinol Invest 1985;8:571–6.10.1007/BF03348564Search in Google Scholar PubMed

7. Giovanella L, Keller F, Ceriani L, Tozzoli R. Heterophile antibodies may falsely increase or decrease thyroglobulin measurements in patients with differentiated thyroid carcinoma. Clin Chem Lab Med 2009;47:952–4.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000268507800009&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

8. Verburg FA, Waschle K, Reiners C, Giovanella L, Lentjes EG. Heterophile antibodies rarely influence the measurement of thyroglobulin and thyroglobulin-antibodies in differentiated thyroid cancer patients. Horm Metab Res 2010;42:736–73.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000281595500007&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1055/s-0030-1254132Search in Google Scholar PubMed

9. Schaadt B, Feldt-Rasmussen U, Rasmusson B, Tørring H, Foder B, Jørgensen K, et al. Assessment of the influence of thyroglobulin (Tg) autoantibodies and other interfering factors on the use of serum Tg as tumor marker in differentiated thyroid carcinoma. Thyroid 1995;5:165–70.10.1089/thy.1995.5.165Search in Google Scholar PubMed

10. Giovanella L, Ceriani L. Comparison of thyroglobulin antibody interference in first- and second-generation thyroglobulin immunoassays. Clin Chem Lab Med 2011;49:1025–27.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000291429500014&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

11. Spencer C, Bergoglio LM, Kazarosyan M, Fatemi S, LoPresti JS. Clinical impact of thyroglobulin (Tg) and Tg autoantibody method differences on the management of patients with differentiated thyroid carcinomas. J Clin Endocrinol Metab 2005;90:5566–75.10.1210/jc.2005-0671Search in Google Scholar PubMed

12. Pacini F, Schlumberger M, Dralle H, Elisei R, Smit JW, et al. European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol 2006;154:787–803.10.1530/eje.1.02158Search in Google Scholar PubMed

13. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167–214.10.1089/thy.2009.0110http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000271440100007&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

14. Baloch Z, Carayon P, Conte-Devolx B, Demers LM, Feldt-Rasmussen U, Henry JF, et al. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid diseases. Thyroid 2003;13:3–126.10.1089/105072503321086962Search in Google Scholar PubMed

15. Krahn J, Dembinski T. Thyroglobulin and anti-thyroglobulin assays in thyroid cancer monitoring. Clin Biochem 2009;42:416–19.10.1016/j.clinbiochem.2008.12.017http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000264309400104&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

16. Spencer C, Petrovic I, Fatemi S. Current thyroglobulin autoantibody (TgAb) assays often fail to detect interfering TgAb that can result in the reporting of falsely low/undetectable serum Tg IMA values for patients with differentiated thyroid cancer. J Clin Endocrinol Metab 2011;96:1283–91.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000290210600029&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1210/jc.2010-2762Search in Google Scholar PubMed

17. Algeciras-Schiminich A, Lasho MA, Ness KM, Cheryk LA, Grebe SK. The Roche Elecsys and Siemens-Centaur thyroglobulin autoantibody assays show comparable clinical performance to the recently unavailable Beckman-Coulter access thyroglobulin autoantibody assay in identifying samples with potentially false-low thyroglobulin measurements due to thyroglobulin autoantibody interference. Thyroid 2011;21:813–4.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000292139300020&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1089/thy.2011.0158Search in Google Scholar PubMed PubMed Central

18. Giovanella L, Maffioli M, Ceriani L, De Palma D, Spriano G. Unstimulated high sensitive thyroglobulin measurement predicts outcome of differentiated thyroid carcinoma. Clin Chem Lab Med 2009;47:1001–4.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000268507800017&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

19. Zophel K, Wunderlich G, Liepach U, Koch R, Bredow J, Franke WG. Recovery test or immunoradiometric measurement of anti-thyroglobulin autoantibodies for interpretation of thyroglobulin determination in the follow-up of differentiated thyroid carcinoma. Nuklearmedizin 2001;40:155–63.10.1055/s-0038-1623881Search in Google Scholar PubMed

20. Persoon AC, Links TP, Wilde J, Sluiter WJ, Wolffenbuttel BH, van der Ouweland JM. Thyroglobulin (Tg) recovery testing with quantitative Tg antibody measurement for determining interference in serum Tg assays in differentiated thyroid carcinoma. Clin Chem 2006;52:1196–9.10.1373/clinchem.2005.060103Search in Google Scholar PubMed

21. Verburg FA, Grelle I, Giovanella L, Reiners C. The thyroglobulin ‘mini-recovery’ testing on the automated BRAHMS KRYPTOR platform is a valid addition to conventional Tg and recovery testing in thyroid healthy subjects. Horm Metab Res 2012;44:555–7.10.1055/s-0032-1314804Search in Google Scholar PubMed

22. Giovanella L. Toffalori E, Ceriani L, Caputo M, Verburg FA. Thyroglobulin and thyroglobulin autoantibodies measurement using the automated KRYPTOR® platform in patients with differentiated thyroid carcinoma. Horm Metab Res 2011;43:728–30.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000295026800011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1055/s-0031-1285868Search in Google Scholar PubMed

23. Dimeski G. Interference testing. Clin Biochem Rev 2008;29:S43–S48.Search in Google Scholar PubMed

24. Bolstad N, Warren DJ, Bjerner J, Kravdal G, Schwettemann L, Olsen KH, et al. Heterophilic antibody interference in commercial immunoassays: a screening study using paired native and pre-blocked sera. Clin Chem Lab Med 2011;49:2001–6.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000299856700010&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

Received: 2012-06-13
Accepted: 2012-07-18
Published Online: 2012-08-19
Published in Print: 2013-02-01

©2013 by Walter de Gruyter Berlin Boston

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