Measurement of Monoclonal Immunoglobulin Protein Concentration in Serum Protein Electrophoresis: Comparison of Automated vs Manual/Human Readings.

Background Protein concentration of monoclonal immunoglobulin in plasma-cell myeloma/multiple myeloma provides an estimate of the tumor mass and allows for monitoring of the response to treatment. Accurate and reproducible estimates of the monoclonal immunoglobulin concentration are important for pa...

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Publicado en:Laboratory Medicine Vol. 51; no. 3; pp. 252 - 259
Autores principales: Clavijo, Alex, Ryan, Nathan, Xu, Hongyan, Singh, Gurmukh
Formato: pictorial research Journal Article
Publicado: Oxford University Press / USA May2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2020
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      pub: Oxford University Press / USA
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        10.1093/labmed/lmz055
        143250546
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        atl: Measurement of Monoclonal Immunoglobulin Protein Concentration in Serum Protein Electrophoresis: Comparison of Automated vs Manual/Human Readings.
      aug:
        au:
          Clavijo, Alex
          Ryan, Nathan
          Xu, Hongyan
          Singh, Gurmukh
        affil: Department of Pathology, Medical College of Georgia at Augusta University, Augusta, GA
      sug:
        subj:
          Antibodies, Monoclonal Blood
          Immunoglobulins Blood
          Proteins Blood
          Blood Protein Electrophoresis
          Human
          Comparative Studies
          Pathologists
          T-Tests
          Analysis of Variance
          Correlation Coefficient
          Regression
          Densitometry
          Multiple Myeloma
          Retrospective Design
          Tertiary Health Care
          United States
          Gels
          Brain
      ab: Background Protein concentration of monoclonal immunoglobulin in plasma-cell myeloma/multiple myeloma provides an estimate of the tumor mass and allows for monitoring of the response to treatment. Accurate and reproducible estimates of the monoclonal immunoglobulin concentration are important for patient care. Objective To address the optimum method for estimation of the concentration of monoclonal immunoglobulins. Methods Serum protein electrophoresis and immunofixation electrophoresis were conducted by using the Helena SPIFE Touch instrument. Estimation of the protein concentration of monoclonal immunoglobulin in the gamma region by computer-assisted reading was compared with the reading by technologists and pathology residents, in 300 gels. The data were compared using t -testing and analysis of variance. Results Computer-generated readings had a consistent positive bias. The correlation coefficient of the average reading by technologists and residents with the computer generated value was 0.997. The average positive bias by the computer reading was 0.29 g per dL. The intercept on the regression analysis was 0.22 g per dL. The reading by the computer was significantly higher than each of the human-interpreted readings. The readings by the 3 human groups were not significantly different amongst them. The main reason for the higher reading by the computer was inclusion of a greater area on the anodal size of the peak on the densitometric scan. Conclusions Human- and computer-interpreted readings of the protein concentration of monoclonal immunoglobulin have a high degree of correlation. The consistent positive bias by the computer reading occurred due to inclusion of a greater area of the densitometric scan on the anodal side of the peak. We suggest that vendors should adjust such computer programs to provide readings comparable to those generated by expert humans. We recommend manual delineation of the monoclonal peaks for measuring the concentration of monoclonal immunoglobulins.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        Journal Article
      ougenre: Article
    language: English
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