Tamama Kenichi
Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, United States; Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA 15213, United States; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, United States; Clinical Laboratory, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15224, United States.
Clin Chim Acta. 2021 Mar;514:40-47. doi: 10.1016/j.cca.2020.12.010. Epub 2020 Dec 14.
Drugs of abuse testing is widely used clinically and forensically. Urine is the preferred type of specimen for drugs of abuse screening, but saliva, sweat, hair, and meconium are emerging types of specimens. GC-MS has been used as a gold standard for confirmatory drug testing, but LC-tandem-MS can analyze more diverse types of analytes than GC-MS. Thus, LC-tandem-MS becomes a new gold standard for confirmatory drug testing. Unlike GC-MS, LC-tandem-MS is not suited for non-targeted comprehensive drug screening. But with the advent of high-resolution-MS such as Tof-MS, which can discriminate the compounds of similar molecular masses but with different formulas, LC-hybrid-Tof-MS is usable for non-targeted comprehensive drug screening. Another technical advancement is the advent of miniature ambient ionization MS, which can analyze biological specimens including urine within one minute. Thus these mass spectrometers are promising for rapid drugs of abuse testing in a POC setting.
滥用药物检测在临床和法医学中被广泛应用。尿液是滥用药物筛查的首选标本类型，但唾液、汗液、毛发和胎粪是新兴的标本类型。气相色谱 - 质谱联用（GC-MS）一直被用作确证药物检测的金标准，但液相色谱 - 串联质谱（LC-tandem-MS）比GC-MS能分析更多种类的分析物。因此，LC-tandem-MS成为确证药物检测的新金标准。与GC-MS不同，LC-tandem-MS不适合非靶向全面药物筛查。但随着高分辨率质谱如飞行时间质谱（Tof-MS）的出现，其能区分分子量相似但分子式不同的化合物，液相色谱 - 混合飞行时间质谱（LC-hybrid-Tof-MS）可用于非靶向全面药物筛查。另一项技术进步是微型常压电离质谱的出现，它能在一分钟内分析包括尿液在内的生物标本。因此，这些质谱仪有望在即时检测（POC）环境中实现快速滥用药物检测。
