1
|
van Rossum HH, Holdenrieder S, Ballieux BEPB, Badrick TC, Yun YM, Zhang C, Patel D, Thelen M, Song J, Wojtalewicz N, Unsworth N, Vesper HW, Cui W, Ramanathan LV, Sturgeon C, Meng QH. Investigating the Current Harmonization Status of Tumor Markers Using Global External Quality Assessment Programs: A Feasibility Study. Clin Chem 2024; 70:669-679. [PMID: 38385453 DOI: 10.1093/clinchem/hvae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/11/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND The harmonization status of most tumor markers (TMs) is unknown. We report a feasibility study performed to determine whether external quality assessment (EQA) programs can be used to obtain insights into the current harmonization status of the tumor markers α-fetoprotein (AFP), prostate specific antigen (PSA), carcinoembryonic antigen (CEA), cancer antigen (CA)125, CA15-3 and CA19-9. METHODS EQA sample results provided by 6 EQA providers (INSTAND [Germany], Korean Association of External Quality Assessment Service [KEQAS, South Korea], National Center for Clinical Laboratories [NCCL, China], United Kingdom National External Quality Assessment Service [UK NEQAS, United Kingdom], Stichting Kwaliteitsbewaking Medische Laboratoriumdiagnostiek [SKML, the Netherlands], and the Royal College of Pathologists of Australasia Quality Assurance Programs [RCPAQAP, Australia]) between 2020 and 2021 were used. The consensus means, calculated from the measurement procedures present in all EQA programs (Abbott Alinity, Beckman Coulter DxI, Roche Cobas, and Siemens Atellica), was used as reference values. Per measurement procedure, the relative difference between consensus mean for each EQA sample and the mean of all patient-pool-based EQA samples were calculated and compared to minimum, desirable, and optimal allowable bias criteria based on biological variation. RESULTS Between 19040 (CA15-3) and 25398 (PSA) individual results and 56 (PSA) to 76 (AFP) unique EQA samples were included in the final analysis. The mean differences with the consensus mean of patient-pool-based EQA samples for all measurement procedures were within the optimum bias criterion for AFP, the desirable bias for PSA, and the minimum bias criterion for CEA. However, CEA results <8 µg/L exceeded the minimum bias criterion. For CA125, CA15-3, and CA19-9, the harmonization status was outside the minimum bias criterion, with systematic differences identified. CONCLUSIONS This study provides relevant information about the current harmonization status of 6 tumor markers. A pilot harmonization investigation for CEA, CA125, CA15-3, and CA19-9 would be desirable.
Collapse
Affiliation(s)
- Huub H van Rossum
- Department of Laboratory Medicine, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Stefan Holdenrieder
- Institute of Laboratory Medicine, Munich Biomarker Research Center, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Duesseldorf, Germany
| | - Bart E P B Ballieux
- Department of Clinical Chemistry, Leiden University Medical Center, Leiden, the Netherlands
| | - Tony C Badrick
- RCPA Quality Assurance Programs, St Leonards, Sydney, Australia
| | - Yeo-Min Yun
- Department of Laboratory Medicine, Konkuk University Medical Center, Seoul, South Korea
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, China
| | - Dina Patel
- UK NEQAS Immunology, Immunochemistry & Allergy, Northern General Hospital, Sheffield, United Kingdom
| | - Marc Thelen
- SKML, Nijmegen, the Netherlands
- Department of Laboratory Medicine of the Radboud University Medical Center, Nijmegen, the Netherlands
| | - Junghan Song
- Department of Laboratory Medicine, Seoul National University Bundang Hospital and College of Medicine, Seongnam, South Korea
| | - Nathalie Wojtalewicz
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Duesseldorf, Germany
| | - Nick Unsworth
- UK NEQAS [Edinburgh], Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Wei Cui
- Department of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lakshmi V Ramanathan
- Clinical Chemistry Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Catharine Sturgeon
- UK NEQAS [Edinburgh], Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Qing H Meng
- Department of Laboratory Medicine, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| |
Collapse
|
2
|
Bratt O, Godtman RA, Jiborn T, Wallström J, Akre O, Carlsson S, Nordström T, Thimansson E, Alterbeck M, Zackrisson S, Hugosson J, Bjartell A, Lantz A. Population-based Organised Prostate Cancer Testing: Results from the First Invitation of 50-year-old Men. Eur Urol 2024; 85:207-214. [PMID: 38042646 DOI: 10.1016/j.eururo.2023.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/27/2023] [Accepted: 11/14/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND The European Union recently recommended evaluation of the feasibility of organised prostate cancer screening. In Sweden, regional population-based organised prostate cancer testing (OPT) programmes were introduced in 2020. OBJECTIVE To describe initial participation rates and diagnostic outcomes. DESIGN, SETTING, AND PARTICIPANTS The three most populated Swedish regions invited all men aged 50 yr to OPT by a letter in 2020-2022. Men with prostate-specific antigen (PSA) ≥3 ng/ml were referred for prostate magnetic resonance imaging (MRI). PSA assays differed across regions. Men with Prostate Imaging Reporting and Data System (PI-RADS) 1-3 and PSA density ≥0.15 ng/ml/cm3 or PI-RADS 4-5 were referred for a biopsy. Data were obtained from the Swedish Register for Organised Prostate Cancer Testing. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Overall and regional participation rates, PSA distributions, PI-RADS score distributions, cancer detection, and treatment were evaluated. RESULTS AND LIMITATIONS A total of 23 855 (35%) of 68 060 invited men participated; 696 (2.9%) had PSA ≥3 ng/ml, and of them, 306 (44%) had a biopsy indication and 221 (32%) had a biopsy. On biopsy, 93 (42%) had Gleason grade group ≥2 (0.39% of PSA-tested men) and 44 (20%) Gleason grade group 1 cancer. Most men with cancer had treatment with curative intent (70%) or were under active surveillance (28%). Across regions, proportions of men with PSA ≥3 ng/ml ranged from 2.3% to 4.0%, and those with PI-RADS score 4-5 ranged from 12% to 21%. A limitation is that results are applicable only to first testing of men in their early 50s. CONCLUSIONS The OPT programmes are feasible with good compliance to the diagnostic pathway. The use of MRI and PSA density avoided a biopsy for over half of the men with PSA ≥3 ng/ml. Inter-regional differences in diagnostic outcomes show a need for standardisation of the diagnostic pathway's components. PATIENT SUMMARY We report the diagnostic outcomes of inviting 68 000 50-yr-old men to organised prostate cancer testing.
Collapse
Affiliation(s)
- Ola Bratt
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Rebecka Arnsrud Godtman
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Thomas Jiborn
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Jonas Wallström
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Olof Akre
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Stefan Carlsson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Tobias Nordström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Erik Thimansson
- Department of Translational Medicine, Faculty of Medicine, Lund University, Lund, Sweden; Department of Radiology, Helsingborg Hospital, Helsingborg, Sweden
| | - Max Alterbeck
- Department of Urology, Skåne University Hospital, Malmö, Sweden; Department of Translational Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| | - Sophia Zackrisson
- Department of Translational Medicine, Faculty of Medicine, Lund University, Lund, Sweden; Department of Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
| | - Jonas Hugosson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Bjartell
- Department of Urology, Skåne University Hospital, Malmö, Sweden; Department of Translational Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| | - Anna Lantz
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
3
|
Garg S, Sachdeva A, Peeters M, McClements J. Point-of-Care Prostate Specific Antigen Testing: Examining Translational Progress toward Clinical Implementation. ACS Sens 2023; 8:3643-3658. [PMID: 37830899 PMCID: PMC10616866 DOI: 10.1021/acssensors.3c01402] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023]
Abstract
Prostate cancer (PCa) is the second most common male cancer and is attributable to over 375,000 deaths annually. Prostate specific antigen (PSA) is a key biomarker for PCa and therefore measuring patient PSA levels is an important aspect of the diagnostic pathway. Automated immunoassays are currently utilized for PSA analysis, but they require a laboratory setting with specialized equipment and trained personnel. This results in high diagnostic costs, extended therapeutic turnaround times, and restrictions on testing capabilities in resource-limited settings. Consequently, there is a strong drive to develop point-of-care (PoC) PSA tests that can offer accurate, low-cost, and rapid results at the time and place of the patient. However, many emerging PoC tests experience a trade-off between accuracy, affordability, and accessibility which distinctly limits their translational potential. This review comprehensively assesses the translational advantages and limitations of emerging laboratory-level and commercial PoC tests for PSA determination. Electrochemical and optical PSA sensors from 2013 to 2023 are systematically examined. Furthermore, we suggest how the translational potential of emerging tests can be optimized to achieve clinical implementation and thus improve PCa diagnosis globally.
Collapse
Affiliation(s)
- Saweta Garg
- Merz
Court, School of Engineering, Newcastle
University, Claremont Road, NE1 7RU Newcastle upon Tyne, U.K.
- Department
of Chemical Engineering and Analytical Science, School of Engineering, University of Manchester, Manchester M20 4BX, U.K.
| | - Ashwin Sachdeva
- Division
of Cancer Sciences, University of Manchester, Wilmslow Road, Manchester M20 4BX, U.K.
- Department
of Urology, The Christie NHS Foundation
Trust, Manchester M20 4BX, U.K.
| | - Marloes Peeters
- Merz
Court, School of Engineering, Newcastle
University, Claremont Road, NE1 7RU Newcastle upon Tyne, U.K.
| | - Jake McClements
- Merz
Court, School of Engineering, Newcastle
University, Claremont Road, NE1 7RU Newcastle upon Tyne, U.K.
| |
Collapse
|
4
|
Filella X, Izquierdo L, Mases J, Youngren KA, Escolar G. Discrepancies in PSA values among laboratories: the case of a traveling patient. Clin Chem Lab Med 2023; 61:e179-e181. [PMID: 36872637 DOI: 10.1515/cclm-2023-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/21/2023] [Indexed: 03/07/2023]
Affiliation(s)
- Xavier Filella
- Department of Biochemistry and Molecular Genetics (CDB), Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Laura Izquierdo
- Department of Urology (ICNU), Hospital Clinic, Barcelona, Spain
| | - Joel Mases
- Department of Oncologic Radiotherapy (ICMHO), Hospital Clinic, Barcelona, Spain
| | - Kjell A Youngren
- Morristown Medical Center, Department of Surgery, Section of Urology, Morristown, NJ, USA
| | - Gines Escolar
- Department of Pathology (CDB), Hospital Clinic, Barcelona, Spain
| |
Collapse
|
5
|
Filella X, Rodríguez-Garcia M, Fernández-Galán E. Clinical usefulness of circulating tumor markers. Clin Chem Lab Med 2022; 61:895-905. [PMID: 36394981 DOI: 10.1515/cclm-2022-1090] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/18/2022]
Abstract
Abstract
Tumor markers are a heterogeneous group of substances released by cancer cells into bloodstream, but also expressed by healthy tissues. Thus, very small concentrations can be present in plasma and serum from healthy subjects. Cancer patients tend to show increased levels correlating with tumor bulk, but false positive results could be present in patients with benign conditions. The correct interpretation of TM results could be challenging and many factors should be considered, from pre-analytical conditions to patient concomitant diseases. In this line, the Clinical Chemistry and Laboratory Medicine journal has made important contributions though several publications promoting the adequate use of TM and therefore improving patient safety. TM measurement offers valuable information for cancer patient management in different clinical contexts, such as helping diagnosis, estimating prognosis, facilitating early detection of relapse and monitoring therapy response. Our review analyzes the clinical usefulness of tumor markers applied in most frequent epithelial tumors, based on recent evidence and guidelines.
Collapse
Affiliation(s)
- Xavier Filella
- Department of Biochemistry and Molecular Genetics (CDB) , Hospital Clínic de Barcelona, IDIBAPS , Barcelona , Catalonia , Spain
| | - María Rodríguez-Garcia
- Department of Biochemistry and Molecular Genetics (CDB) , Hospital Clínic de Barcelona, IDIBAPS , Barcelona , Catalonia , Spain
| | - Esther Fernández-Galán
- Department of Biochemistry and Molecular Genetics (CDB) , Hospital Clínic de Barcelona, IDIBAPS , Barcelona , Catalonia , Spain
| |
Collapse
|
6
|
Arsov C, Albers P, Herkommer K, Gschwend J, Imkamp F, Peters I, Kuczyk M, Hadaschik B, Kristiansen G, Schimmöller L, Antoch G, Rummeny E, Wacker F, Schlemmer H, Benner A, Siener R, Kaaks R, Becker N. A Randomized Trial of
Risk‐Adapted
Screening for Prostate Cancer in Young Men ‐ Results of the First Screening Round of the
PROBASE
Trial. Int J Cancer 2022; 150:1861-1869. [DOI: 10.1002/ijc.33940] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/06/2021] [Accepted: 12/21/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Christian Arsov
- Department of Urology University Hospital, Medical Faculty, Heinrich‐Heine University Düsseldorf
| | - Peter Albers
- Department of Urology University Hospital, Medical Faculty, Heinrich‐Heine University Düsseldorf
- Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ) Heidelberg
| | - Kathleen Herkommer
- Department of Urology Technical University of Munich, School of Medicine, Klinikum rechts der Isar
| | - Jürgen Gschwend
- Department of Urology Technical University of Munich, School of Medicine, Klinikum rechts der Isar
| | | | - Inga Peters
- Department of Urology Medical University Hannover
| | | | - Boris Hadaschik
- Department of Urology, University Hospital Essen University of Duisburg‐Essen
- Department of Urology, University Hospital Heidelberg Ruprecht Karls University Heidelberg
| | | | - Lars Schimmöller
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Duesseldorf, Heinrich‐Heine University Düsseldorf Düsseldorf Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Duesseldorf, Heinrich‐Heine University Düsseldorf Düsseldorf Germany
| | - Ernst Rummeny
- Institute of Diagnostic and Interventional Radiology Technical University Munich
| | - Frank Wacker
- Institute of Diagnostic and Interventional Radiology Medical University Hannover
| | - Heinz Schlemmer
- Department of Radiology, German Cancer Research Center (DKFZ) Heidelberg
| | - Axel Benner
- Division of Biostatistics, German Cancer Research Center (DKFZ) Heidelberg
| | | | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ) Heidelberg
| | - Nikolaus Becker
- Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ) Heidelberg
| |
Collapse
|
7
|
Ferraro S, Bussetti M, Rizzardi S, Braga F, Panteghini M. Verification of Harmonization of Serum Total and Free Prostate-Specific Antigen (PSA) Measurements and Implications for Medical Decisions. Clin Chem 2021; 67:543-553. [PMID: 33674839 DOI: 10.1093/clinchem/hvaa268] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/08/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Previous studies have shown that the harmonization of prostate-specific antigen (PSA) assays remained limited even after the introduction of WHO International Standards. This information needs updating for current measuring systems (MS) and reevaluation according to established analytical performance specifications (APS) and the characteristics of antibodies used. METHODS Total (tPSA) and free (fPSA) PSA were measured in 135 and 137 native serum samples, respectively, by Abbott Alinity i, Beckman Access Dxl, Roche Cobas e801, and Siemens Atellica IM MSs. Passing-Bablok regression and difference plots were used to compare results from each MS to the all-method median values. Agreement among methods was evaluated against APS for bias derived from biological variation of the 2 measurands. RESULTS The median interassay CV for tPSA MSs (11.5%; 25-75th percentiles, 9.2-13.4) fulfilled the minimum APS goal for intermethod bias (15.9%), while the interassay CV for fPSA did not [20.4% (25-75th percentiles, 18.4-22.7) vs goal 17.6%]. Considering the all-method median value of each sample as reference, all tPSA MSs exhibited a mean percentage bias within the minimum goal. On the other hand, Alinity (+21.3%) and Access (-24.2%) were out of the minimum bias goal for fPSA, the disagreement explained only in minimal part by the heterogeneity of employed antibodies. CONCLUSIONS The harmonization among tPSA MSs is acceptable only when minimum APS are applied and necessitates further improvement. The marked disagreement among fPSA MSs questions the use of fPSA as a second-level test for biopsy referral.
Collapse
Affiliation(s)
- Simona Ferraro
- Unità Operativa Complessa di Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Marco Bussetti
- Unità Operativa Complessa di Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Sara Rizzardi
- Unità Operativa Laboratorio Analisi Chimico Cliniche e Microbiologiche, ASST Cremona, Cremona, Italy
| | - Federica Braga
- Unità Operativa Complessa di Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy.,Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milan, Italy
| | - Mauro Panteghini
- Unità Operativa Complessa di Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy.,Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milan, Italy
| |
Collapse
|
8
|
Ferraro S, Bussetti M, Panteghini M. Serum Prostate-Specific Antigen Testing for Early Detection of Prostate Cancer: Managing the Gap between Clinical and Laboratory Practice. Clin Chem 2021; 67:602-609. [PMID: 33619518 DOI: 10.1093/clinchem/hvab002] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/21/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Current clinical practice guidelines (CPGs) for early detection of prostate cancer recommend for clinical decision-making a personalized prostate-specific antigen (PSA)-based management to improve the risk-benefit ratio of the screening strategy. Some important critical issues regarding the PSA determination in the clinical framework are, however, still neglected in current guidelines and a major focus of recommendations on those aspects would be needed to improve their effectiveness. CONTENT Evidence sources in the available literature concerning the interchangeability of total PSA results measured with different commercial methods were critically appraised. We discuss how the heterogeneity of the measurand, the intermethod bias, and the design and selectivity of immunoassays may affect the diagnostic accuracy of selected PSA thresholds, and how knowledge of the analytical characteristics of assays in service, such as the recognized PSA circulating forms and the cross-reactivity with PSA homologs, is basic for improving both clinical decision-making in cancer screening and the reliability of the clinical interpretation of results at the individual level. SUMMARY Current CPGs ignore the poor interchangeability of PSA results obtained from different assays and the substantial role of laboratory issues in clinical performance of PSA testing. Involved stakeholders should contribute to fill the existing gap by: (a) preparing commutable reference materials for immunoassay calibration; (b) providing analytical characteristics that may explain the different performance of assays; (c) deriving outcome-based analytical performance specifications for PSA measurement; and (d) giving more focus on laboratory items when CPGs are prepared.
Collapse
Affiliation(s)
- Simona Ferraro
- Department of Biomedical and Clinical Sciences, 'Luigi Sacco', University of Milan, and Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Marco Bussetti
- Department of Biomedical and Clinical Sciences, 'Luigi Sacco', University of Milan, and Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Mauro Panteghini
- Department of Biomedical and Clinical Sciences, 'Luigi Sacco', University of Milan, and Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| |
Collapse
|
9
|
Ferguson J, Patel D, Atkinson E, Rigsby P, Burns C. Continued provision of WHO International Standards for total and free PSA: Content and commutability of replacement preparations. Clin Biochem 2019; 71:58-66. [DOI: 10.1016/j.clinbiochem.2019.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/03/2019] [Accepted: 07/06/2019] [Indexed: 10/26/2022]
|