免疫测定中的干扰:综述与实用算法

L. Wauthier, M. Plebani, J. Favresse
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引用次数: 23

摘要

由于全自动、周转时间短、特异性和敏感性高,免疫测定法是目前测量大量复杂和异质分子的首选方法。尽管表现出色,但免疫测定容易受到几种可能导致对患者有害后果的干扰(例如,处方不充分的治疗,延迟诊断,不必要的侵入性调查)。系统搜索只对一些干扰进行,因为它在临床实验室不实用,因为它会显著影响预算、周转时间和人力资源。因此,在面对异常结果时,通常首选逐案方法。因此,我们回顾了目前对免疫测定干扰的了解,并提出了一种在临床实验室进行干扰检查的算法,从怀疑它们的存在到使用适当的测试来识别它们。我们提出了一种方法来合理化实验室专家在面对潜在干扰时的态度,并强调他们与临床医生和制造商合作的重要性,以确保未来的改进。
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Interferences in immunoassays: review and practical algorithm
Abstract Immunoassays are currently the methods of choice for the measurement of a large panel of complex and heterogenous molecules owing to full automation, short turnaround time, high specificity and sensitivity. Despite remarkable performances, immunoassays are prone to several types of interferences that may lead to harmful consequences for the patient (e.g., prescription of an inadequate treatment, delayed diagnosis, unnecessary invasive investigations). A systematic search is only performed for some interferences because of its impracticality in clinical laboratories as it would notably impact budget, turnaround time, and human resources. Therefore, a case-by-case approach is generally preferred when facing an aberrant result. Hereby, we review the current knowledge on immunoassay interferences and present an algorithm for interference workup in clinical laboratories, from suspecting their presence to using the appropriate tests to identify them. We propose an approach to rationalize the attitude of laboratory specialists when faced with a potential interference and emphasize the importance of their collaboration with clinicians and manufacturers to ensure future improvements.
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