Oris Charlotte, Landrieaux Lise, Brailova Marina, Roszyk Laurence, Rozand Isabelle, Sapin Vincent, Bouvier Damien, Colombier Michèle
Service de biochimie et génétique moléculaire, CHU Clermont-Ferrand, Clermont-Ferrand, France, Université Clermont Auvergne, Faculté de médecine, CNRS 6293, Inserm 1103, GReD, Clermont-Ferrand, France.
Service de biochimie et génétique moléculaire, CHU Clermont-Ferrand, Clermont-Ferrand, France.
Ann Biol Clin (Paris). 2020 Feb 1;78(1):93-107. doi: 10.1684/abc.2020.1524.
The measurement performance of 13 biochemistry parameters (CEA, CA 19-9, amylase, lipase, sodium, potassium, chloride, creatinine, glucose, protein, albumin, LDH, triglycerides) was tested in a panel of biological fluids other than blood and urine (peritoneal, pleural, pancreatic fluids ...). Our protocol, based on a risk analysis, allowed us to justify our choices and compare the performance obtained with those of the serum or plasma matrix already validated. Thus, the coefficients of variation obtained in body fluids are comparable. The assessment of accuracy (spiking and dilution tests) shows the absence of bias, which is consistent with the absence of matrix effect. The linearity studied by dilution tests shows that the upper limits of the measurement interval communicated by the supplier are applicable to body fluids. The absence of contamination and stability have been also confirmed. All analytes are stable for 3 days at room temperature, 7 days between 2 and 8̊C, and 6 months at -20̊C; except LDH and lipase. For most analytes, at least one interference (hemolysis, icterus, lipemia) was found. Finally, a bibliographical study, confronted with the experience of prescribers, led us to define optimal thresholds to help interpret patients' results. In conclusion, this work has allowed us to validate analytical methods for body fluids testing after relying on their comparability to the blood matrix. We have also been able to adapt our practices and finally be accredited according to the standard NF IN ISO 15189.
在一组除血液和尿液之外的生物体液(腹水、胸水、胰液……)中对13项生化参数(癌胚抗原、糖类抗原19-9、淀粉酶、脂肪酶、钠、钾、氯、肌酐、葡萄糖、蛋白质、白蛋白、乳酸脱氢酶、甘油三酯)的测量性能进行了测试。我们基于风险分析的方案使我们能够证明我们的选择合理,并将获得的性能与已经验证的血清或血浆基质的性能进行比较。因此,在体液中获得的变异系数具有可比性。准确性评估(加标和稀释试验)表明不存在偏差,这与不存在基质效应一致。通过稀释试验研究的线性表明供应商公布的测量区间上限适用于体液。污染的不存在和稳定性也得到了证实。所有分析物在室温下可稳定保存3天,在2至8℃之间可稳定保存7天,在-20℃下可稳定保存6个月;乳酸脱氢酶和脂肪酶除外。对于大多数分析物,发现了至少一种干扰(溶血、黄疸、脂血)。最后,一项文献研究结合开处方者的经验,使我们能够定义最佳阈值以帮助解释患者的结果。总之,这项工作使我们能够在依赖体液检测分析方法与血液基质的可比性之后,验证这些方法。我们还能够调整我们的做法,最终根据标准NF IN ISO 15189获得认可。