ketendoКлиническая и экспериментальная тиреоидологияClinical and experimental thyroidology1995-54722310-3787Endocrinology Research Centre10.14341/ket12698ketendo-12698Research ArticleОбзорыReviewsВлияние эндогенных и экзогенных факторов на иммунологические тесты оценки функции щитовидной железыEndogenous and exogenous interferences in thyroid function immunoassayshttps://orcid.org/0000-0001-7879-8495КимЕкатерина ИгоревнаKimEkaterina I.

Клинический ординатор, eLibrary SPIN: 1628-2139.

117036, Москва, ул. Дм. Ульянова, д. 11, телефон: 8 (985) 721-87-86

Clinical resident; eLibrary SPIN: 1628-2139.

11 Dm. Ulyanova street, 117036 Moscow

kat-alex2007@mail.ruhttps://orcid.org/0000-0002-1359-8297ДимитроваДиана АршалуйсовнаDimitrovaDiana А.

eLibrary SPIN: 5618-8971.

117036, Москва, ул. Дм. Ульянова, д. 11

M.D.; eLibrary SPIN: 5618-8971.

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diadavtyan@gmail.comhttps://orcid.org/0000-0003-2094-8731КатамадзеНино НиколаевнаDimitrovaDiana A.

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117036, Москва, ул. Дмитрия Ульянова, д. 11, к. 2

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11 Dm. Ulyanova street, 117036 Moscow

nincho.1994@mail.ruhttps://orcid.org/0000-0002-0807-9230ДзантиеваТамара СергеевнаKatamadzeNino N.

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117036, Москва, ул. Дмитрия Ульянова, д. 11, к. 2

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Dmitry Ulyanova street 11 bld 2, 117036 Moscow

dzantievat@yandex.ruhttps://orcid.org/0000-0001-6539-466XПигароваЕкатерина АлександровнаDzantievaTamara S.

Доктор медицинских наук, eLibrary SPIN: 6912-6331; Scopus Author ID 55655098500; Researcher ID T-9424-2018.

117036, Москва, ул. Дмитрия Ульянова, д. 11

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Dmitry Ulyanova street 11 bld 2, 117036 Moscow

kpigarova@gmail.comНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian Federation2020170320211631624Copyright © Ким Е.И., Димитрова Д.А., Катамадзе Н.Н., Дзантиева Т.С., Пигарова Е.А., 20212021Ким Е.И., Димитрова Д.А., Катамадзе Н.Н., Дзантиева Т.С., Пигарова Е.А.Kim E.I., Dimitrova D.А., Dimitrova D.A., Katamadze N.N., Dzantieva T.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cet-endojournals.ru/jour/article/view/12698

Лабораторная диагностика эндокринных заболеваний за последние десятилетия претерпела множество важных изменений, но, несмотря на прогресс технологий иммуноаналитических тестов, используемых для оценки функции щитовидной железы, нельзя полностью исключить факторы, способные изменять концентрацию исследуемого вещества, что может, в свою очередь, приводить к неправильной интерпретации и последующим ошибочным клиническим решениям. Вероятность таких ошибочных результатов составляет около 1%. Однако масштаб проблемы может быть больше вследствие неосведомленности врачей о данной проблеме и отсутствия лабораторного скрининга на наличие вмешивающихся факторов. Данные факторы могут быть как эндогенными, так и экзогенными, связываться как с антителами к исследуемому веществу, так и реагентом в тест-системе. Специфичность иммуноанализа зависит не только от связывающих свойств антитела, активности реагента, но также от состава тест-панели и формата методики (неконкурентный двухсайтовый или «сэндвич-формат» и конкурентный иммуноанализ).

В этом обзоре представлено описание основных аналитических ошибок, которые влияют на измерение гормонов щитовидной железы, в частности тиреотропного гормона, свободных тироксина и трийодтиронина, кальцитонина, приводятся клинические примеры, описанные в литературе за последние несколько лет.

Laboratory diagnosis of endocrine diseases has undergone many important changes over the past decades, despite the progress of thyroid function immunoassays technologies interferences cannot be completely excluded. These interferences can affect measurement of analyte which leads to misinterpretation and subsequent wrong clinical decisions, the probability of which is about 1%. However, the scale of the problem may be greater due to the lack of awareness to the problem among doctors and the lack of laboratory screening for interfering factors. These factors can be both endogenous and exogenous, bind both to antibodies to the analyte and to the reagent in the test system. The specificity of the immunoassay depends not only on the binding properties of antibodies, the activity of reagent, but also on the composition of the test system and the format of the methodology (non-competitive two-site or “sandwich” and competitive assays).

This review provides a description of the main interferences that can affect the measurement of thyroid hormones, in particular thyroid stimulating hormone, free thyroxine and triiodothyronine, calcitonin, and demonstrates clinical cases reported in the literature over the past few years.

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The authors declare that there are no conflicts of interest present.