Berkshire and Surrey Pathology Services, Frimley Park Hospital NHS Trust, Camberley, UK.
NHS Bowel Cancer Screening Programme Southern Hub, Royal Surrey County Hospital, Surrey GU2 7YS, UK.
Clin Chem Lab Med. 2020 Jun 25;58(6):1010-1017. doi: 10.1515/cclm-2019-0834.
Background Liquid chromatography-tandem mass spectrometry (LC-MS/MS) offers advantages over immunoassay due to its increased specificity and ability to multiplex metabolites within a single run. Wide scale adoption of LC-MS/MS in routine clinical laboratories is restricted in part due to the high level of technical expertise required. The Thermo Scientific™ Cascadion™ SM Clinical Analyzer is the first fully automated, random access clinical analyser that utilises LC-MS/MS technology. We report an analytical validation of the 25-hydroxy vitamin D2 and D3 assays on the Cascadion Analyzer and an assessment of its performance within a routine clinical laboratory. Methods Analyser usability was assessed by staff with no previous experience of LC-MS/MS. An analytical validation included analysis of 154 patient samples on two different Cascadion Analyzers and a four-way method comparison of 146 patient samples on Roche and Siemens immunoassays and an in-house LC-MS/MS method. Accuracy was assessed using external quality assurance and reference materials. Seven third party IQC materials were tested on Cascadion. Results Cascadion proved easy to use by scientific and non-scientific staff. The assay passed all validation criteria. Excellent agreement was demonstrated between two different Cascadions (y = 0.97x + 3.9 nmol/L, r2 > 0.99). A method comparison demonstrated no significant difference (p > 0.05) between the Cascadion and the Roche immunoassay. A significant difference (p < 0.0001) was observed between the Cascadion and an LC-MS/MS and Siemens methods. Results obtained from EQA and reference material showed a mean bias of +3.09% and all samples were within ±10% of assigned concentrations. All third party IQC samples tested were compatible for use with Cascadion. Conclusions The Cascadion Analyzer is a fully automated LC-MS/MS system that requires no prior LC-MS/MS expertise. The vitamin D assays demonstrated excellent performance with high levels of accuracy.
背景 液相色谱-串联质谱(LC-MS/MS)由于其特异性增加和能够在单次运行中同时检测多种代谢物,因此优于免疫测定。LC-MS/MS 在常规临床实验室中的广泛采用受到限制,部分原因是需要高水平的技术专业知识。赛默飞世尔科技™ Cascadion™ SM 临床分析仪是首个完全自动化、随机存取的临床分析仪,它采用 LC-MS/MS 技术。我们报告了 Cascadion 分析仪上 25-羟维生素 D2 和 D3 检测的分析验证,并评估了其在常规临床实验室中的性能。
方法 无 LC-MS/MS 经验的工作人员评估了分析仪的可用性。分析验证包括在两台不同的 Cascadion 分析仪上分析 154 例患者样本,以及在罗氏和西门子免疫测定以及内部 LC-MS/MS 方法上对 146 例患者样本进行四路方法比较。使用外部质量保证和参考材料评估准确性。在 Cascadion 上测试了 7 种第三方 IQC 材料。
结果 Cascadion 被证明对科学和非科学人员来说都易于使用。该检测通过了所有验证标准。两台不同的 Cascadion 之间显示出极好的一致性(y=0.97x+3.9 nmol/L,r2>0.99)。方法比较表明 Cascadion 与罗氏免疫测定之间没有显著差异(p>0.05)。Cascadion 与 LC-MS/MS 和西门子方法之间观察到显著差异(p<0.0001)。EQA 和参考材料的结果显示平均偏差为+3.09%,所有样本均在指定浓度的±10%范围内。所有第三方 IQC 样本均与 Cascadion 兼容。
结论 Cascadion 分析仪是一种完全自动化的 LC-MS/MS 系统,不需要事先具备 LC-MS/MS 专业知识。维生素 D 检测具有出色的性能和高精度。