高泌乳素血症中巨泌乳素筛查方法的研究
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摘要
目的:探讨高泌乳素血症中巨泌乳素(M-PRL)对泌乳素(PRL)检测的干扰及应用血清稀释聚乙二醇(PEG)沉淀法筛查M-PRL血症(MP)的可行性。方法:收集84例PRL>30.0 ng/mL病人血清标本,分别使用25%PEG沉淀法及25%PEG沉淀5倍稀释后的血清标本法测定高泌乳素血症病人的PRL水平,以回收率<50%为判断MP的临界值。采用ROC曲线评价血清稀释PEG沉淀法和PEG沉淀法对MP的诊断价值。结果:使用25%PEG沉淀5倍稀释后的血清标本法对真泌组和巨泌组的PRL回收率分别是116.0%和63.0%,分别高于传统的PEG沉淀法中PRL的回收率的42.0%和101.0%(P<0.05和P<0.01);且血清稀释PEG沉淀法对真性高泌乳素血症检出率98.53%,高于PEG沉淀法的检出率88.23%(P<0.05)。血清稀释PEG沉淀法和PEG沉淀法诊断MP的ROC曲线下面积分别为0.939 (0.851～1.0)和0.932(0.828～1.0)。结论:采用25%PEG沉淀5倍稀释后的血清标本法可以增加PRL的回收率,提高真性高泌乳素血症的检出率。
Objective:To explore the effects of macroprolactin on the detection of prolactin(PRL),and the feasibility of the serum dilution polyethylene glycol(PEG) precipitation method in the screening of hyperprolactinemia(MP).Methods:The PRL levels in blood samples of 84 patients with serum PRL level >30.0 ng/mL were detected using the 5-fold dilution 25% PEG and PEG precipitation method.The recovery rate of PRL less than 50% was used as the standard for MP screening.The value of 25% PEG and 5-fold dilution 25% PEG in the diagnosis of MP were evaluated using ROC curve.Results:The recovery rates of PRL in the eutrophic and hypertrophic groups were 116.0% and 63.0% using 5-fold dilution PEG precipitation method,and which was higher than those in traditional PEG precipitation method(42.0% and 101.0%),respectively(P<0.05 and P<0.01).The detection rate of dilution PEG precipitation method in genuine MP was 98.53%,which was higher than that of PEG precipitation method(88.23%)(P<0.05).The area under the ROC curve of dilution PEG and PEG precipitation methods in diagnosing MP were 0.939(0.851 to 1.0) and 0.932(0.828 to 1.0),respectively.Conclusions:The 5-fold dilution PEG precipitation method can increase the recovery rate of PRL and detection rate of genuine MP.
Objective:To explore the effects of macroprolactin on the detection of prolactin(PRL),and the feasibility of the serum dilution polyethylene glycol(PEG) precipitation method in the screening of hyperprolactinemia(MP).Methods:The PRL levels in blood samples of 84 patients with serum PRL level >30.0 ng/mL were detected using the 5-fold dilution 25% PEG and PEG precipitation method.The recovery rate of PRL less than 50% was used as the standard for MP screening.The value of 25% PEG and 5-fold dilution 25% PEG in the diagnosis of MP were evaluated using ROC curve.Results:The recovery rates of PRL in the eutrophic and hypertrophic groups were 116.0% and 63.0% using 5-fold dilution PEG precipitation method,and which was higher than those in traditional PEG precipitation method(42.0% and 101.0%),respectively(P<0.05 and P<0.01).The detection rate of dilution PEG precipitation method in genuine MP was 98.53%,which was higher than that of PEG precipitation method(88.23%)(P<0.05).The area under the ROC curve of dilution PEG and PEG precipitation methods in diagnosing MP were 0.939(0.851 to 1.0) and 0.932(0.828 to 1.0),respectively.Conclusions:The 5-fold dilution PEG precipitation method can increase the recovery rate of PRL and detection rate of genuine MP.
引文
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[8] CHEN YJ,WANG H,YANG W,et al.A new method of using polyethylene glycol(PEG) precipitation of macroprolactin to detect genuine hyperprolactinemia[J].J Clin Lab Anal,2016,30(6):1169.
[9] MCCUDDEN CR,SHARPLESS JL,GRENACHE DG.Comparison of multiple methods for identi cation of hyperprolactinemia in the presence of macroprolactin[J].Clin Chim Acta,2010,411(3/4):155.
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[11] KASUM M,JURAS J.Importance of macroprolactinemia in hyperprolactinemia[J].Eur J Obstet Gynecol,2014,183:28.
[12] KAVANAGH L,MCKENNA TJ,FAHIE-WILSON MN,et al.Specificity and clinical utility of methods for the detection of macroprolactin[J].Clin Chem,2006,52(7):1366.
[13] 陈丽芬,朱惠君,黄雪飞,等.聚乙二醇沉淀法筛查巨泌乳素对高泌乳素血症的诊断价值[J].黑龙江医学,2016,40(9):875.
[14] 陈允,周道祥.高泌乳素血症诊断中巨泌乳素筛查试验的临床应用[J].中国处方药,2015,13(6):2.
[15] 秦辛玲,石青峰,姚军.巨泌乳素筛查在高泌乳素血症诊断中的临床意义[J].检验医学与临床,2015,12(5):672.
[16] KRYSIAK R,DROSDZOL A,OKOPIEN B,et al.Sexual function and depressive symptoms in young women with elevated macroprolactin content:a pilot study[J].Endocrine,2016,53(1):291.
[17] SAMSON SL,HAMRAHIAN AH,EZZAT S,et al.American association of clinical endocrinologists,American college of endocrinology disease state clinical review:clinical relevance of macroprolactin in the absence or presence of true hyperprolactinemia[J].Endocr Pract,2015,21(12):1427.
[2] HUANG W,MOLITCH ME.Evaluation and management of galactorrhea[J].Am Fam Physician,2012,85(11):1073.
[3] OLUKOGA AO,KANE JW.Macroprolactinaemia:validation and application of the polyethylene glycol precipitation test and clinical characterization of the condition[J].Clin Endocrinol,1999,51(1):119.
[4] LIPPI G,PLEBANI M.Plebani,Macroprolactin:searching for a needle in a haystack?[J].Clin Chem Lab Med,2016,54(4):519.
[5] HATTORI N,NAKAYAMA Y,KITAGAWA K,et al.Anti-prolactin (PRL) autoantibody-binding sites (epitopes) on PRL molecule in macroprolactinemia[J].J Endocrinol,2006,190(2):287.
[6] HATTORI N,NAKAYAMA Y,KITAGAWA K,et al.Development of antiPRL (prolactin) autoantibodies by homologous PRL in rats:a model for macroprolactinemia[J].Endocrinology,2007,148(5):2465.
[7] CHEN YJ,ZHOU YL,XU L,et al.Screening and detection of patients with macroprolactinemia by application of polyethylene glycol precipitation method[J].Zhejiang Da Xue Xue Bao Yi Xue Ban,2014,43(2):187.
[8] CHEN YJ,WANG H,YANG W,et al.A new method of using polyethylene glycol(PEG) precipitation of macroprolactin to detect genuine hyperprolactinemia[J].J Clin Lab Anal,2016,30(6):1169.
[9] MCCUDDEN CR,SHARPLESS JL,GRENACHE DG.Comparison of multiple methods for identi cation of hyperprolactinemia in the presence of macroprolactin[J].Clin Chim Acta,2010,411(3/4):155.
[10] ELENKOVA A,GENOV N,ABADZHIEVA Z,et al.Macroprolactinemia in patients with prolactinomas:prevalence and clinical significance[J].Exp Clin Endocrinol Diabetes,2013,121(4):201.
[11] KASUM M,JURAS J.Importance of macroprolactinemia in hyperprolactinemia[J].Eur J Obstet Gynecol,2014,183:28.
[12] KAVANAGH L,MCKENNA TJ,FAHIE-WILSON MN,et al.Specificity and clinical utility of methods for the detection of macroprolactin[J].Clin Chem,2006,52(7):1366.
[13] 陈丽芬,朱惠君,黄雪飞,等.聚乙二醇沉淀法筛查巨泌乳素对高泌乳素血症的诊断价值[J].黑龙江医学,2016,40(9):875.
[14] 陈允,周道祥.高泌乳素血症诊断中巨泌乳素筛查试验的临床应用[J].中国处方药,2015,13(6):2.
[15] 秦辛玲,石青峰,姚军.巨泌乳素筛查在高泌乳素血症诊断中的临床意义[J].检验医学与临床,2015,12(5):672.
[16] KRYSIAK R,DROSDZOL A,OKOPIEN B,et al.Sexual function and depressive symptoms in young women with elevated macroprolactin content:a pilot study[J].Endocrine,2016,53(1):291.
[17] SAMSON SL,HAMRAHIAN AH,EZZAT S,et al.American association of clinical endocrinologists,American college of endocrinology disease state clinical review:clinical relevance of macroprolactin in the absence or presence of true hyperprolactinemia[J].Endocr Pract,2015,21(12):1427.