摘要
目的建立基于液相色谱-串联质谱(liquid chromatography-tandem mass spectrometry,LC-MS/MS)的激素测定平台,并与化学发光免疫分析(chemiluminescence immunoassay,CLIA)测定的血清睾酮(T)、硫酸脱氢表雄酮(DHEA-S)、孕酮(P4)和雌二醇(E2)水平进行对比,明确该LC-MS/MS平台诊断高雄激素血症和多囊卵巢综合征(polycystic ovary syndrome,PCOS)的临床价值。方法纳入PCOS患者35例(PCOS组),正常对照组33例,LC-MS/MS测定血清T、雄烯二酮(A4)、DHEA-S、双氢睾酮(DHT)、脱氢表雄酮(DHEA)、P4、E2、雌酮(E1)、雌三醇(E3)、17-羟孕酮(17-OHP)、皮质醇和可的松水平,并与CLIA测定的血清T、DHEA-S、P4和E2水平进行比较,ROC曲线分析LC-MS/MS测定的血清T、A4和E1水平诊断PCOS的曲线下面积、灵敏度、特异度和约登指数、阳性预测值和阴性预测值。结果LC-MS/MS测定的血清T、DHEA-S、P4和E2水平均低于CLIA,差异有统计学意义(P<0.05)。LC-MS/MS联合检测T、A4、DHEA-S、DHT和DHEA可以提高高雄激素血症的检出率(P<0.05)。PCOS患者的血清T、A4和E1水平均高于正常对照组,差异有统计学意义(P<0.05),ROC曲线亦提示LC-MS/MS测定血清T、A4和E1水平诊断PCOS有临床价值(P<0.05)。结论LC-MS/MS激素测定平台检测多项雄激素能提高高雄激素血症的检出率,较CLIA能更好的识别PCOS患者。
Objective A hormone determination platform based on liquid chromatography-tandem mass spectrometry(LC-MS/MS)was established to compare the levels of serum testosterone(T),dehydroepiandrosterone sulfate(DHEA-S),progesterone(P4),and estradiol(E2)with those measured by CLIA.This comparison clarified the clinical value of the LC-MS/MS platform for the diagno⁃sis of hyperandrogenism and polycystic ovary syndrome(PCOS).Methods 35 patients with PCOS and 33 normal controls were in⁃cluded.Serum levels of testosterone(T),4-androstenedione(A4),dehydroepiandrosterone sulfate(DHEA-S),dihydrotestosterone(DHT),dehydroepiandrosterone(DHEA),progesterone(P4),estradiol(E2),estrone(E1),estriol(E3),17-hydroxyprogesterone(17-OHP),cortisol,and cortisone were measured by LC-MS/MS and compared with CLIA-measured levels of serum T,DHEA-S,P4,and E2.The area under the curve,sensitivity,specificity,and Jordon's index,as well as the positive predictive value and negative pre⁃dictive value of ROC curves,were analyzed to diagnose PCOS using serum T,A4,and E1 levels measured by LC-MS/MS.Results The levels of serum T,DHEA-S,P4 and E2 measured by LC-MS/MS were lower than those of CLIA,the differences were statistically signifi⁃cant(P<0.05).The detection rate of hyperandrogenism could be improved by the combined detection of T,A4,DHEA-S,DHT and DHEA by LC-MS/MS(P<0.05).The serum levels of T,A4 and E1 in patients with PCOS were higher than that of the normal controls(P<0.05).The ROC curves also suggested that the determination of serum T,A4 and E1 levels by LC-MS/MS were valuable for the di⁃agnosis of PCOS(P<0.05).Conclusions The LC-MS/MS hormone assay platform could improve the detection rate of multiple andro⁃gens,enhancing the diagnosis of hyperandrogenemia and better identifying PCOS patients compared to CLIA.
作者
李凯俊
张燊
何帆
LI Kaijun;ZHANG Shen;HE Fan(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;The Center for Reproductive Medicine,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)
出处
《西南医科大学学报》
2024年第3期221-225,共5页
Journal of Southwest Medical University
基金
国家自然科学基金(82101710)。
关键词
多囊卵巢综合征
液相色谱-串联质谱法
化学发光免疫分析法
高雄激素血症
睾酮
双氢睾酮
Polycystic Ovary Syndrome
Liquid Chromatography-Tandem Mass Spectrometry
Chemiluminescence Immunoas⁃say
Hyperandrogenism
Testosterone
Dihydrotestosterone
