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To skim or splice? Comparing the quantification of M-proteins using two peak-integration protocols across multiple
J J Miller1, J Taher2, V Kulasingam3
1Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.
Clinical Biochemistry
|January 30, 2022
Summary
The tangential skim (TS) method for M-protein quantification provides lower results than the perpendicular drop (PD) method, especially at concentrations below 15 g/L. This difference can significantly impact clinical decisions for monoclonal gammopathies.
Area of Science:
- Clinical Chemistry
- Immunology
- Medical Diagnostics
Background:
- M-protein quantification is crucial for diagnosing and monitoring monoclonal gammopathies.
- Serum protein electrophoresis (SPE) is a standard method, with perpendicular drop (PD) and tangential skim (TS) being two integration protocols.
- The TS protocol offers potentially more accurate M-protein estimation by excluding background proteins, but its adoption is limited.
Purpose of the Study:
- To compare M-protein quantification differences between PD and TS methods across various concentrations.
- To evaluate the impact of these differences on clinical interpretation and patient management.
- To highlight the importance of understanding method variations before switching protocols.
Main Methods:
- Retrospective analysis of M-protein quantification using PD and TS protocols.
- Investigation conducted on three major electrophoresis platforms.
- Analysis of M-protein concentrations across a wide range, with a focus on levels below 15 g/L.
Main Results:
- The TS method consistently yielded lower M-protein values compared to the PD method.
- Differences were most pronounced at concentrations below 15 g/L, with average differences ranging from -81% to -95%.
- Above 15 g/L, the average difference was less pronounced, ranging from -13% to -31%.
Conclusions:
- Switching to the TS method requires careful consideration of potential concentration changes.
- Platform-dependent differences in M-protein quantification can impact patient classification and management.
- Understanding the clinical implications of TS adoption is paramount for accurate patient care.
