Advertisement

Indian Journal of Clinical Biochemistry

, Volume 34, Issue 4, pp 465–471 | Cite as

Comparison of Serum Thyroglobulin Levels in Differentiated Thyroid Cancer Patients Using In-House Developed Radioimmunoassay and Immunoradiometric Procedures

  • Chandrakala Gholve
  • J. Kumarasamy
  • Archana Damle
  • Savita Kulkarni
  • Meera Venkatesh
  • Sharmila Banerjee
  • M. G. R. RajanEmail author
Original Research Article
  • 43 Downloads

Abstract

Thyroglobulin (Tg) is a proven tumor marker in the follow-up and post-operative management of patients with differentiated thyroid cancer (DTC). All assays for serum thyroglobulin (s-Tg) are based on immunoassays, however, the assay technique has a bearing on the variations seen in the estimations. We studied this using four in-house developed radioimmunoassays (RIA) and immunoradiometric assays (IRMA). Limit of detection, working range, recovery, dilution test, precision profiles and method comparison were evaluated. All four methods were used for the estimation of s-Tg in DTC patients and also compared for their performance using commercially available Tg IRMA kits from DiaSorin and Izotop. The s-Tg values measured by six different immunoassays showed very significant inter-method correlation (0.84–0.99, p < 0.001). However, among the in-house developed assays; the coated tube IRMA showed a better sensitivity and precision at the lower concentration range and hence, is preferable for the routine measurement of s-Tg in patients negative for Tg autoantibodies (TgAb). Although the second generation IRMAs offer practical benefits of having higher sensitivity, shorter turn-around time and convenience of automation, they, unfortunately, also have higher tendency for interference from both TgAb and heterophilic antibodies, if present in the sample. On the contrary, RIA is less prone to such interference and, hence, can be used in patients with TgAb. In order to effectively use this test, it is important that nuclear medicine physicians and endocrinologists understand these intrinsic technical limitations encountered during s-Tg measurement.

Keywords

Differentiated thyroid cancer Immunoradiometric assay Radioimmunoassay Thyroglobulin Thyroglobulin autoantibodies 

Notes

Compliance with Ethical Standards

Conflict of interest

Chandrakala Gholve, J. Kumarasamy, Archana Damle, Savita Kulkarni, Meera Venkatesh, Sharmila Banerjee and M. G. R. Rajan declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Evans C, Tennant S, Perros P. Serum thyroglobulin in the monitoring of differentiated thyroid cancer. Scand J Clin Lab Invest. 2016;76(sup245):S119–23.  https://doi.org/10.1080/00365513.2016.1210339.CrossRefGoogle Scholar
  2. 2.
    Spencer CA, LoPresti J, Fatemi S. How sensitive (second-generation) thyroglobulin measurement is changing paradigms for monitoring patients with differentiated thyroid cancer, in the absence or presence of thyroglobulin autoantibodies. Curr Opin Endocrinol Diabetes Obes. 2014;21(5):394–404.CrossRefGoogle Scholar
  3. 3.
    Jain B, Kulkarni S, Gholve C, Kumarasamy J, Rajan MGR. A sensitive solid-phase micro-spot radio-tracer assay for the simultaneous estimation of thyroid stimulating hormone and thyroglobulin. Indian J Appl Res. 2015;5(9):269–71.Google Scholar
  4. 4.
    Jain B, Kumarasamy J, Gholve C, Kulkarni S, Rajan MGR. A multi-analyte immunoassay for thyroid related analytes. J Immunoassay Immunochem. 2017;38(3):271–84.CrossRefGoogle Scholar
  5. 5.
    Jain B, Kumarasamy J, Gholve C, Kulkarni S, Rajan MGR. A microarray mmunoassay for serum thyrotropin and thyroglobulin using antibodies immobilized on track-etched membranes. Indian J Clin Biochem. 2017;32(2):193–9.CrossRefGoogle Scholar
  6. 6.
    Lee JI, Kim JY, Choi JY, Kim HK, Jang HW, Hur KY, et al. Differences in serum thyroglobulin measurements by 3 commercial immunoradiometric assay kits and laboratory standardization using Certified Reference Material 457 (CRM-457). Head Neck. 2010;32(9):1161–6.CrossRefGoogle Scholar
  7. 7.
    Gholve C, Kumarasamy J, Kulkarni S, Rajan MGR. In-house solid-phase radioassay for the detection of anti-thyroglobulin autoantibodies in patients with differentiated thyroid cancer. Indian J Clin Biochem. 2017;32(1):39–44.CrossRefGoogle Scholar
  8. 8.
    Kumar A, Devdhar MN, Shah DH, Ganatra RD. Use of double antibody and Staphylococcus aureus as a separating agent in RIA of thyroglobulin. Indian J Med Res. 1985;82:248–53.PubMedGoogle Scholar
  9. 9.
    Gholve C, Kumarasamy J, Damle A, Kulkarni S, Rajan MGR. Development of a two-step immunoradiometric assay for serum thyroglobulin using a combination of polyclonal and monoclonal antibodies. Indian J Appl Res. 2016;6(3):468–72.Google Scholar
  10. 10.
    Spencer CA, Takeuchi M, Kazarosyan M, Wang CC, Guttler RB, Singer PA, et al. Serum thyroglobulin autoantibodies: prevalence, influence on serum thyroglobulin measurement and prognostic significance in patients with differentiated thyroid carcinoma. J Clin Endicrinol Metab. 1998;83:1121–7.Google Scholar
  11. 11.
    Spencer CA, Wang CC. Thyroglobulin measurement: techniques, clinical benefits, and pitfalls. Endocrinol Metab Clin North Am. 1995;24(4):841–63.CrossRefGoogle Scholar
  12. 12.
    Iervasi A, Iervasi G, Carpi A, Zucchelli GC. Serum thyroglobulin measurement: clinical background and main methodological aspects with clinical impact. Biomed Pharmacother. 2006;60(8):414–24.CrossRefGoogle Scholar
  13. 13.
    Persoon ACM, Johannes MW, Ouweland VD, Wilde J, Kema IP, Wolffenbuttel BHR, et al. Clinical utility of an automated immunochemiluminometric thyroglobulin assay in differentiated thyroid carcinoma. Clin Chem. 2006;52(4):686–91.CrossRefGoogle Scholar
  14. 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 disease. Thyroid. 2003;13:3–126.CrossRefGoogle Scholar
  15. 15.
    Stanojevic M, Savin S, Cvejic D, Djukic A, Jeremic M, Simonovic SZ. Comparison of the influence of thyroglobulin antibodies on serum thyroglobulin values from two different immunoassays in post surgical differentiated thyroid carcinoma patients. J Clin Lab Anal. 2009;23:341–6.CrossRefGoogle Scholar

Copyright information

© Association of Clinical Biochemists of India 2018

Authors and Affiliations

  1. 1.Homi Bhabha National Institute, Radiation Medicine CentreBARC, TMH AnnexeParel, MumbaiIndia
  2. 2.Division of Physical and Chemical Sciences, Department of Nuclear Sciences and ApplicationsInternational Atomic Energy Agency (IAEA)ViennaAustria

Personalised recommendations