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Thyrotropin binding inhibitory immunoglobulin (TBII) and thyroid diseases using ROC analysis
C Sulman1, P Gosselin, J L Cazin
1Centre Oscar-Lambret, Lille, France.
Pathologie-Biologie
|February 1, 1990
Summary
Measuring thyrotropin binding inhibitory immunoglobulin (TBII) is a valuable assay for diagnosing autoimmune hyperthyroidism. This easy-to-perform test demonstrates good sensitivity and specificity in identifying the condition.
Area of Science:
- Endocrinology
- Immunology
- Diagnostic Assay Development
Background:
- Autoimmune hyperthyroidism diagnosis can be challenging.
- Thyrotropin binding inhibitory immunoglobulin (TBII) assays detect antibodies that inhibit TSH binding to the TSH receptor.
Purpose of the Study:
- To evaluate the diagnostic utility of the TBII assay for autoimmune hyperthyroidism.
- To determine the optimal cut-off value for the TBII assay based on disease prevalence.
Main Methods:
- Receiver Operating Characteristic (ROC) curve analysis was used to assess assay performance.
- The study included 196 patients: 128 with autoimmune hyperthyroidism and 68 with other thyroid diseases.
- Cut-off values were determined for varying disease prevalences (10-80%).
Main Results:
- An ideal cut-off for the TBII assay was established between 13.5% and 7.5% across different prevalences.
- Using a 9% cut-off, the assay achieved 87.5% sensitivity and 87% specificity in the studied group.
- False positives and negatives were noted, linked to the assay measuring TSH binding site occupation rather than physiological activity.
Conclusions:
- The TBII assay is a practical and effective tool for diagnosing autoimmune hyperthyroidism.
- Despite limitations, the assay's ease of performance makes it a valuable diagnostic aid.