免疫分析法之"hook effect"：病例報告及偵測方法探討

"Hook Effect" in Immunometric Assay: A Case Report and Discussion of Detection Methods

10.6332/ANMS.1404.014

施並富(Bing-Fu Shih)；王安美(An-Mei Wang)；莊嘉莉(Chia-Lie Chuang)

下鉤效應 ； 放射免疫分析法 ； 雙位點夾心放射免疫法 ； hook effect ； immunometric assay ； radioimmunoassay

核子醫學雜誌

14卷4期（2001 / 12 / 01）

247 - 250

繁體中文

一位20歲女性病息，因為月經週期延遲而來求診，懷孕試驗為陽性反應，人類絨毛膜性腺激素（β-hCG）使用IRMA方法測定為486.05 mIU/Ml，病患隨後接受手術，病理檢查證實為水囊狀胎塊。後來將原檢體經過連續稀釋後重新檢驗，發現β-hCG實際是大約627,000 mIU/mL，證實是由於hook effect所致。Hook effect雖然很少見，但是可能影響臨床的診斷和治療，本文將探討有效的偵測方法。

A 20-year-old female visited our hospital due to delayed menstruation. Pregnancy test showed positive result. Serum level of ß-hCG (human chorionic gonadotropin, ß-subunit) was 486.05 mIU/mL using an IRMA method. The patient received an operation of suction D&C under the impression of molar pregnancy. Hydatidiform mole was proven by pathologic examination. A retest of the original blood sample after serial dilution was performed and the exact ß-hCG value of this patient before operation was 627,000 mIU/mL. We considered the incorrect ß-hCG result in previous test might be secondary to hook effect in IRMA method. Hook effect occurs infrequently but may have serious clinical implications. In this article, the authors would like to discuss the effective detection methods.