{"title":"类风湿因子所致CA199假性升高1例并文献复习。","authors":"Hong-Gang Sun, Ming-Feng Yang, Jian-Qing Zhang, Ying Zhang","doi":"10.7754/Clin.Lab.2025.250356","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>When CA199 is solely elevated, it may be a false increase due to interference. Rheumatoid factor (RF), an autoantibody binding to the Fc fragment of denatured IgG, can interfere with immunological tests.</p><p><strong>Methods: </strong>Chemiluminescent immunoassay was used to detect tumor markers. For this patient, to exclude false CA199 elevation, PEG precipitation, serial dilution, and platform switching were applied.</p><p><strong>Results: </strong>In the PEG precipitation test, the patient's sample formed flocs. Post-PEG treatment, CA199 dropped from 179.62 U/mL to 17.66 U/mL (9.83% recovery), suggesting interference. Serial dilution showed a non-linear CA199 relationship, further indicating interference. Platform switching revealed significant results: Abbott's platform measured CA199 at 179.62 U/mL, while Mindray's was 18.68 U/mL.</p><p><strong>Conclusions: </strong>RFis an IgG antibody and can disrupt immunological tests. When encountering high RF in reports, consider its interference on other immunological tests. Use methods like sample dilution, spiking/recovery tests, platform switching, and comparing related test results to verify interference and ensure detection accuracy.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"71 8","pages":""},"PeriodicalIF":0.6000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pseudo Elevation of CA199 Caused by Rheumatoid Factor: a Case Report and Literature Review.\",\"authors\":\"Hong-Gang Sun, Ming-Feng Yang, Jian-Qing Zhang, Ying Zhang\",\"doi\":\"10.7754/Clin.Lab.2025.250356\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>When CA199 is solely elevated, it may be a false increase due to interference. Rheumatoid factor (RF), an autoantibody binding to the Fc fragment of denatured IgG, can interfere with immunological tests.</p><p><strong>Methods: </strong>Chemiluminescent immunoassay was used to detect tumor markers. For this patient, to exclude false CA199 elevation, PEG precipitation, serial dilution, and platform switching were applied.</p><p><strong>Results: </strong>In the PEG precipitation test, the patient's sample formed flocs. Post-PEG treatment, CA199 dropped from 179.62 U/mL to 17.66 U/mL (9.83% recovery), suggesting interference. Serial dilution showed a non-linear CA199 relationship, further indicating interference. Platform switching revealed significant results: Abbott's platform measured CA199 at 179.62 U/mL, while Mindray's was 18.68 U/mL.</p><p><strong>Conclusions: </strong>RFis an IgG antibody and can disrupt immunological tests. When encountering high RF in reports, consider its interference on other immunological tests. Use methods like sample dilution, spiking/recovery tests, platform switching, and comparing related test results to verify interference and ensure detection accuracy.</p>\",\"PeriodicalId\":10384,\"journal\":{\"name\":\"Clinical laboratory\",\"volume\":\"71 8\",\"pages\":\"\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical laboratory\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.7754/Clin.Lab.2025.250356\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"MEDICAL LABORATORY TECHNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical laboratory","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.7754/Clin.Lab.2025.250356","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
Pseudo Elevation of CA199 Caused by Rheumatoid Factor: a Case Report and Literature Review.
Background: When CA199 is solely elevated, it may be a false increase due to interference. Rheumatoid factor (RF), an autoantibody binding to the Fc fragment of denatured IgG, can interfere with immunological tests.
Methods: Chemiluminescent immunoassay was used to detect tumor markers. For this patient, to exclude false CA199 elevation, PEG precipitation, serial dilution, and platform switching were applied.
Results: In the PEG precipitation test, the patient's sample formed flocs. Post-PEG treatment, CA199 dropped from 179.62 U/mL to 17.66 U/mL (9.83% recovery), suggesting interference. Serial dilution showed a non-linear CA199 relationship, further indicating interference. Platform switching revealed significant results: Abbott's platform measured CA199 at 179.62 U/mL, while Mindray's was 18.68 U/mL.
Conclusions: RFis an IgG antibody and can disrupt immunological tests. When encountering high RF in reports, consider its interference on other immunological tests. Use methods like sample dilution, spiking/recovery tests, platform switching, and comparing related test results to verify interference and ensure detection accuracy.
期刊介绍：
Clinical Laboratory is an international fully peer-reviewed journal covering all aspects of laboratory medicine and transfusion medicine. In addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies. The journal publishes original articles, review articles, posters, short reports, case studies and letters to the editor dealing with 1) the scientific background, implementation and diagnostic significance of laboratory methods employed in hospitals, blood banks and physicians'' offices and with 2) scientific, administrative and clinical aspects of transfusion medicine and 3) in addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies.
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