Startseite Total serum vitamin B12 (cobalamin) LC-MS/MS assay as an arbiter of clinically discordant immunoassay results
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Total serum vitamin B12 (cobalamin) LC-MS/MS assay as an arbiter of clinically discordant immunoassay results

  • Ruiping Zhang , Xiaoli Ma , Yutong Zou , Ling Qiu , Danchen Wang , Yueming Tang , Yongtong Cao , Songlin Yu EMAIL logo und Xinqi Cheng EMAIL logo
Veröffentlicht/Copyright: 15. September 2022
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Clinical Chemistry and Laboratory Medicine (CCLM)
Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine (CCLM) Band 61 Heft 1

Abstract

Objectives

Measurement of the serum levels of vitamin B12 (VB12) is key for evaluating VB12 deficiency-dependent anemia. Immunoassay, the major method for determining VB12, tends to give false-normal results because of the presence of anti-intrinsic factor (IF-Ab) or other factors such as heterophilic antibodies et al. This study aimed to develop a liquid chromatography tandem mass spectrometry (LC-MS/MS) method that is helpful for distinguish false normal VB12 results measured by the immunoassay.

Methods

Different forms of VB12 were derivatized into CN-B12, which was collected through solid-phase extraction and analyzed via LC-MS/MS. 236 serum samples were measured both by LC-MS/MS and immunoassay, results were compared, and the IF-Ab effect was evaluated.

Results

The LC-MS/MS assay afforded a linear slope from 20 to 4,000 pmol/L for CN-B12. OH-VB12, methyl-VB12, and CoA-VB12 showed recovery within 89.3–109.5%. The intra-assay CV of VB12 was 2.6–4.1%, whereas the total CV was 9.3–9.8%. Passing–Bablok regression between LC-MS/MS and immunoassay results showed that the slope was 1.085 and the intercept was −15.691. The Bland–Altman plot showed that the mean difference and difference% were −34.6 pmol/L and 0.3%, respectively. Inter-rater agreement analysis showed that the linear weighted kappa value was 0.885, implying good agreement between the two methods. However, two samples were falsely elevated and one sample was falsely normal in the immunoassay compared with LC-MS/MS. The LC-MS/MS method helped in the distinction of false-normal VB12 results shown by the immunoassay.

Conclusions

The VB12 LC-MS/MS method can be used as an arbiter of clinically discordant immunoassay results.

Keywords: cobalamin; interference; liquid chromatography tandem mass spectrometry; vitamin B12
Corresponding authors: Songlin Yu, MD and Xinqi Cheng, MD, Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, P.R. China, Phone: +86 01069159707, Fax +86 01069159712, E-mail: (S. Yu), (X. Cheng)

Ruiping Zhang, Xiaoli Ma and Yutong Zou contributed equally to this article.

Funding source: National Key Research and Development Program of China http://dx.doi.org/10.13039/501100012166

Award Identifier / Grant number: 2021YFC2401100

Funding source: National High Level Hospital Clinical Research Funding

Award Identifier / Grant number: 2022-PUMCH-A-138

  1. Research funding: This work was funded by the National Key Research and Development Program of China (No. 2021YFC2401100), and National High Level Hospital Clinical Research Funding (2022-PUMCH-A-138). The funding bodies were not involved in conducting or analyzing this work or in the decision to publish. The authors have no additional financial disclosures.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ Institutional Review Board (Peking Union Medical College Hospital) or equivalent committee. (ZS-2795).

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2022-0523).

Received: 2022-05-30
Accepted: 2022-08-30
Published Online: 2022-09-15
Published in Print: 2023-01-27

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

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  2. Editorial
  3. A new milestone on the road to global standardization of apolipoprotein measurements
  4. Review
  5. Saliva – a new opportunity for fluid biopsy
  6. Opinion Papers
  7. Emerging technology: a definition for laboratory medicine
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  9. EFLM Paper
  10. The new, race-free, Chronic Kidney Disease Epidemiology Consortium (CKD-EPI) equation to estimate glomerular filtration rate: is it applicable in Europe? A position statement by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)
  11. Guidelines and Recommendations
  12. Overcoming challenges regarding reference materials and regulations that influence global standardization of medical laboratory testing results
  13. General Clinical Chemistry and Laboratory Medicine
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  15. Report from the HarmoSter study: inter-laboratory comparison of LC-MS/MS measurements of corticosterone, 11-deoxycortisol and cortisone
  16. The influence of proteoforms: assessing the accuracy of total vitamin D-binding protein quantification by proteolysis and LC-MS/MS
  17. Total serum vitamin B12 (cobalamin) LC-MS/MS assay as an arbiter of clinically discordant immunoassay results
  18. The preanalytical process in the emergency department, a European survey
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  20. Umbilical cord blood gases: probability of arterial or venous source in acidemia
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  22. Pediatric reference interval verification for 17 specialized immunoassays and cancer markers on the Abbott Alinity i system in the CALIPER cohort of healthy children and adolescents
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  26. Managing the impact of inter-method bias of prostate specific antigen assays on biopsy referral: the key to move towards precision health in prostate cancer management
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  28. Quantitation of cardiac troponin I in cancer patients treated with immune checkpoint inhibitors: a case-control study
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  31. Technical and health governance aspects of the External Quality Assessment Scheme for the SARS-CoV-2 molecular tests: institutional experience performed in all clinical laboratories of a Regional Health Service
  32. Acknowledgment
  33. Acknowledgment
  34. Letters to the Editor
  35. About the estimation of albuminuria based on proteinuria results
  36. Response to “About the estimation of albuminuria based on proteinuria results”
  37. Reply to Abildgaard et al.: lot variation and inter-device differences contribute to poor analytical performance of the DCA vantage™ HbA1c POCT instrument in a true clinical setting
  38. Reply to letter from Mayfield et al. regarding “Lot variation and inter-device differences contribute to poor analytical performance of the DCA Vantage™ HbA1c POCT instrument in a true clinical setting”
  39. High-sensitive cardiac troponin T: are turbulences coming?
  40. Analytical performance evaluation of bioactive adrenomedullin on point-of-care platform
  41. Increased PD-L1 surface expression on peripheral blood granulocytes and monocytes after vaccination with SARS-CoV2 mRNA or vector vaccine
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https://doi.org/10.1515/cclm-2022-0523
Schlagwörter für diesen Artikel
cobalamin; interference; liquid chromatography tandem mass spectrometry; vitamin B12

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. A new milestone on the road to global standardization of apolipoprotein measurements
  4. Review
  5. Saliva – a new opportunity for fluid biopsy
  6. Opinion Papers
  7. Emerging technology: a definition for laboratory medicine
  8. The next wave of innovation in laboratory automation: systems for auto-verification, quality control and specimen quality assurance
  9. EFLM Paper
  10. The new, race-free, Chronic Kidney Disease Epidemiology Consortium (CKD-EPI) equation to estimate glomerular filtration rate: is it applicable in Europe? A position statement by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)
  11. Guidelines and Recommendations
  12. Overcoming challenges regarding reference materials and regulations that influence global standardization of medical laboratory testing results
  13. General Clinical Chemistry and Laboratory Medicine
  14. Quantitative protein mass-spectrometry requires a standardized pre-analytical phase
  15. Report from the HarmoSter study: inter-laboratory comparison of LC-MS/MS measurements of corticosterone, 11-deoxycortisol and cortisone
  16. The influence of proteoforms: assessing the accuracy of total vitamin D-binding protein quantification by proteolysis and LC-MS/MS
  17. Total serum vitamin B12 (cobalamin) LC-MS/MS assay as an arbiter of clinically discordant immunoassay results
  18. The preanalytical process in the emergency department, a European survey
  19. Proenkephalin A as a marker for glomerular filtration rate in critically ill children: validation against gold standard iohexol GFR measurements
  20. Umbilical cord blood gases: probability of arterial or venous source in acidemia
  21. Reference Values and Biological Variations
  22. Pediatric reference interval verification for 17 specialized immunoassays and cancer markers on the Abbott Alinity i system in the CALIPER cohort of healthy children and adolescents
  23. Hematology and Coagulation
  24. Performance of digital morphology analyzer CellaVision DC-1
  25. Cancer Diagnostics
  26. Managing the impact of inter-method bias of prostate specific antigen assays on biopsy referral: the key to move towards precision health in prostate cancer management
  27. Cardiovascular Diseases
  28. Quantitation of cardiac troponin I in cancer patients treated with immune checkpoint inhibitors: a case-control study
  29. Infectious Diseases
  30. A novel scoring system combining Modified Early Warning Score with biomarkers of monocyte distribution width, white blood cell counts, and neutrophil-to-lymphocyte ratio to improve early sepsis prediction in older adults
  31. Technical and health governance aspects of the External Quality Assessment Scheme for the SARS-CoV-2 molecular tests: institutional experience performed in all clinical laboratories of a Regional Health Service
  32. Acknowledgment
  33. Acknowledgment
  34. Letters to the Editor
  35. About the estimation of albuminuria based on proteinuria results
  36. Response to “About the estimation of albuminuria based on proteinuria results”
  37. Reply to Abildgaard et al.: lot variation and inter-device differences contribute to poor analytical performance of the DCA vantage™ HbA1c POCT instrument in a true clinical setting
  38. Reply to letter from Mayfield et al. regarding “Lot variation and inter-device differences contribute to poor analytical performance of the DCA Vantage™ HbA1c POCT instrument in a true clinical setting”
  39. High-sensitive cardiac troponin T: are turbulences coming?
  40. Analytical performance evaluation of bioactive adrenomedullin on point-of-care platform
  41. Increased PD-L1 surface expression on peripheral blood granulocytes and monocytes after vaccination with SARS-CoV2 mRNA or vector vaccine
  42. Neopterin level can be measured by intraocular liquid biopsy
  43. The stability of pleural fluid pH under slushed ice and room temperature conditions
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