Lab Med Qual Assur.  2022 Jun;44(2):111-120. 10.15263/jlmqa.2022.44.2.111.

Commutability Assessment of Frozen Human Serum Pools for External Quality Assessment of Tumor Markers

Affiliations
  • 1Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
  • 2Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 3Department of Laboratory Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
  • 4Department of Laboratory Medicine, Green Cross Laboratories, Yongin, Korea
  • 5Department of Laboratory Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Background
Commutability is essential to harmonize different measuring systems and to evaluate the performance of participating laboratories in external quality assessment (EQA). This study aims to assess the com mutability of EQA materials in the tumor marker program of the Korean Association of External Quality Assessment Service.
Methods
We analyzed commercial quality control (QC) materials, individual patient samples, and frozen human serum pools (FSPs) based on the Clinical and Laboratory Standards Institute guidelines. Alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), and total prostate-specific antigen (PSA) were assayed in triplicate in all samples using four analytical systems at the three laboratories. The results obtained from pairs of assays were plotted and assessed using Deming regression analysis. The criterion for commutability was a 95% prediction interval, and bias for noncommutability was calculated.
Results
FSPs were commutable in all AFP, CEA, and total PSA assay methods. Bias for AFP, CEA, and total PSA ranged from –203% to 27%, –67% to 45%, and –9% to 12%, respectively. Commercial QC materials for AFP and PSA were commutable in four assays, whereas for CEA, noncommutability was observed.
Conclusions
Our results validated that the frozen serum pools were commutable across different platforms for tumor marker assays. Therefore, validation findings from materials like FSPs and information about their commutability needs to be reported, for the applicability of EQA programs.

Keyword

Commutability; External quality assessment; Frozen human serum pools; Immunoassay; Tumor biomarkers
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