lopment And Diagnostic Use Of Rapid Immunoassays

几种内分泌肿瘤标志物被常规用于各种癌症的诊断和治疗。然而，目前的分析通常需要几个小时的时间才能完成，这排除了它们在患者术中管理中的使用。大多数内分泌肿瘤标志物在循环中的半衰期不到5分钟，因此，如果有快速检测方法，在手术或定位过程中监测激素浓度是可行的。这种化验的主要适应症是评估术后残留肿瘤的程度，并通过选择性静脉或动脉采样来定位肿瘤。在过去的一年里，我们已经完成了一种新的完整的PTH检测方法的开发，该方法不与PTH的7-84片段发生交叉反应。我们比较了新旧快速甲状旁腺激素测定法，发现甲状旁腺切除术后新测法甲状旁腺激素衰变更快。我们还完成了对颈静脉样本进行ACTH快速检测的可能诊断用途的分析。结果表明，在约50%的库欣病病例中，这种检测方法可用于避免岩静脉采样的需要。在接下来的一年里，我们计划进一步开发一种用于定位胃泌素瘤的快速胃泌素检测方法。

Several endocrine tumor markers are routinely used in the diagnosis and management of various cancers. The current assays, however, typically take several hours to perform, which precludes their use in the intraoperative management of patients. Most endocrine tumor markers have a half-life in the circulation of less than 5 minutes, thus making it feasible, if a rapid assay were available, for monitoring the concentration of the hormones during surgery or localization procedures. The primary indication for such assays would be to assess the extent of residual tumor after surgery and to localize tumors by selective venous or arterial sampling. In the past year, we have completed the development of a new intact PTH assay that does not cross react with the 7-84 fragment of PTH. We have compared the old and new rapid PTH assay and have found that there is faster decay of PTH with the new assay following parathyroidectomy. We have also completed an analysis of the possible diagnostic utilty of a rapid ACTH assay on jugular venous samples. The results showed that such an assay would be useful for preventing the need for petrosal venous sampling in about 50% of the cases for Cushing's disease. In the upcoming year, we plan to further develop a rapid gastrin assay for localizing gastrinomas.