Clin Lab. 2024 Feb 1;70(2). doi: 10.7754/Clin.Lab.2023.230652.
Serum Protein Electrophoresis (SPE) is crucial for the diagnosis and follow-up of monoclonal gammopathy (MG), as it helps to separate and identify these paraproteins. Currently, Pakistan lacks standardized guidelines for SPE reporting and analytical performance. This survey aims to analyze reporting variations from Consultant Chemical Pathologists in Pakistani laboratories.
This cross-sectional survey was conducted by the section of Chemical Pathology, Department of Pathology and Laboratory Medicine, at Aga Khan University Hospital, Karachi. A previously validated and published tool was used with some modifications to assess analytical techniques, reporting patterns, and interpretations provided with SPE by different laboratories. Frequency and percentages were calculated for each response and descriptive results were also evaluated. Differences between laboratories were also assessed qualitatively.
Out of the eight laboratories contacted, seven participated in the survey, yielding a response rate of 87.5%. Immunofixation Electrophoresis (IFE) was used by all labs for serum immunotyping. All labs reported a new small abnormal band in patients with no known monoclonal gammopathy or with a known M-protein. Variations were found in terminologies used to label paraprotein, terminologies used to report normal and pathological SPE patterns, electrophoretic technique, methods for quantifying paraprotein in the gamma region on SPE and for albumin quantification. Similarly, the number of decimal places reported, reporting of multiple monoclonal proteins and small paraprotein in the beta region or monoclonal proteins less than 1 g/L, approach for screening, number of fractions reported in gamma region and reporting of interferences were also not standardized and var-iations were noticed.
Our survey highlighted variations in practices of SPE reporting. These differences in laboratory practices could result in inconsistent test results, which could adversely affect patient care.
血清蛋白电泳（SPE）对于单克隆丙种球蛋白病（MG）的诊断和随访至关重要，因为它有助于分离和鉴定这些副蛋白。目前，巴基斯坦缺乏 SPE 报告和分析性能的标准化指南。本调查旨在分析巴基斯坦实验室顾问化学病理学家的报告差异。
本横断面调查由卡拉奇 Aga Khan 大学医院病理学和检验科化学病理学科进行。使用了先前经过验证和发表的工具，并进行了一些修改，以评估不同实验室的分析技术、报告模式和 SPE 提供的解释。对每个回答计算频率和百分比，并对描述性结果进行评估。还对实验室之间的差异进行了定性评估。
在所联系的八个实验室中，有七个参加了调查，应答率为 87.5%。所有实验室都使用免疫固定电泳（IFE）进行血清免疫分型。所有实验室都报告了在没有已知单克隆丙种球蛋白病或已知 M 蛋白的患者中新出现的小异常带。在用于标记副蛋白的术语、用于报告正常和病理 SPE 模式的术语、电泳技术、用于在 SPE 上定量γ区副蛋白和白蛋白定量的方法方面存在差异。同样，报告的小数位数、报告多发性单克隆蛋白和β区的小副蛋白或低于 1 g/L 的单克隆蛋白、筛选方法、γ区报告的分数数量和报告的干扰也没有标准化，并且注意到存在差异。
我们的调查强调了 SPE 报告实践中的差异。这些实验室实践中的差异可能导致测试结果不一致，从而对患者护理产生不利影响。
