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遗传性代谢疾病:实验室诊断的质量管理。

Inherited metabolic disorders: Quality management for laboratory diagnosis.

机构信息

Centre of Medical Genetics, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110060, India.

Centre of Medical Genetics, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110060, India.

出版信息

Clin Chim Acta. 2015 Jul 20;447:1-7. doi: 10.1016/j.cca.2015.04.040. Epub 2015 May 10.

Abstract

BACKGROUND

The advancements in laboratory technology and knowledge of the mechanisms behind metabolic disorders have facilitated accurate and reliable laboratory testing in screening, diagnosis and treatment of inherited metabolic disorders. Therefore, quality assurance and improvement in diagnostic proficiency have become essential in this area. In most developing countries, standard practices for quality assurance in testing of enzymes, hormones and metabolites involved in these genetic disorders have not been fully implemented. We highlight the benefits of quality assurance and aim to create awareness for greater compliance with the criteria established for quality control to ensure accuracy in biochemical genetic testing.

METHODS

Establishing the limit of detection and testing range for each analyte and enzyme are useful as a reference while setting up new assays. To minimize error, %CV should be monitored regularly. Evaluation of proficiency testing performance provides scope to the laboratory for improving testing quality.

RESULTS

Low precision seen in lysosomal enzyme assays does not undermine their diagnostic efficacy as differentiation between patients and normal subjects is possible by setting % coefficient of variation cutoffs.

CONCLUSIONS

The study will facilitate the collaboration with other screening and diagnostic systems and help in development of new laboratory standards.

摘要

背景

实验室技术的进步和对代谢紊乱机制的了解,使得遗传性代谢紊乱的筛查、诊断和治疗中的实验室检测变得准确可靠。因此,在这一领域,保证质量和提高诊断能力变得至关重要。在大多数发展中国家,尚未全面实施用于检测涉及这些遗传疾病的酶、激素和代谢物的检测质量保证的标准操作程序。我们强调了质量保证的益处,并旨在提高对为确保生化遗传学检测准确性而制定的质量控制标准的合规性的认识。

方法

建立每个分析物和酶的检测限和检测范围作为设置新检测方法的参考。为了最大程度地减少误差,应定期监测 %CV。通过评估性能熟练程度测试,可以为实验室提供提高检测质量的机会。

结果

溶酶体酶检测中看到的低精密度并不会降低其诊断效果,因为通过设置 %变异系数的截止值,可以区分患者和正常人群。

结论

该研究将有助于与其他筛查和诊断系统合作,并有助于开发新的实验室标准。

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