What is the Immunoassay of CA 19-9 Like?
Štern P. 1,2 , Friedecký B. 2,3 , Bartoš V. 4 Bezdíčková D. 1 , Vávrová J. 3 , Uhrová J. 1 , Rozprimová L. 5 , Zima T. 1 Palička V. 3
1 Institute of Clinical Biochemistry, General University Hospital and 1 st Faculty of Medicine, Charles University, Prague 2 Department of Clinical Biochemistry, Institute for Postgraduate Education of Health Care Professionals, Prague 3 Institute of Clinical Biochemistry and Diagnostics, University Hospital, Hradec Králové 4Department of Nuclear Medicine, University Hospital and Policlinics, Ostrava Agilab, Ltd. Praha5 |
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Summary:
In an inter-laboratory study, we compared six routinely employed immunoassay sets: Architect i2000 and
AxSYM, Abbott Laboratories; Elecsys 2010, Roche Diagnostics; ELSA, CIS-BioInternational; Immulite 1, Dia-
gnostic Products Corporation; and IRMA-mat, Byk-Sangtec Diagnostica. Using all analytical systems, we measu-
red identical groups of clinical samples completed with selected calibrators and control samples. The
reproducibility of measurements was calculated from the results of measurements of 21 duplicates of control
materials. The coefficient of variance (CV) values ranged from 2.1% (Elecsys 2010) to 6.7% (ELSA). The parameters
of Passing-Bablok regression show significant systematic differences among analytical systems. Data from
a Bland-Altman diagram suggest that these differences project onto another, still more significant are individual
differences among individual samples. Usually, differences among systems increase with increasing CA 19-9
concentrations. Our aim was to find out whether analytical discrepancies would decrease when we related the
results obtained to the cut-off values for individual analytical sets. Though the cut-off values differ among various
systems, no similar clinical efficacy appears to be attained. The behaviour of indi vidual systems is quite different
for identical control materials and does not necessarily duplicate the calibration for biological samples. We are
presenting the results of analyses of control sera Bio-Rad (difference 72 %) and DGKC (difference 89%). The
results of determining CA 19-9 cannot be generalized from one analytical technique to another, which is even
true in cases where the same monoclonal antibody is used.
Key words:
CA 19-9 immunoassay, intra-assay accuracy, CA 19-9 cut-off value, reliability of results, tumour
marker.
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