Nicole M A White-Al Habeeb1, Tammy Earle2, Megan Spencer2, Ivan M Blasutig3. 1. Department of Laboratory Medicine and Pathobiology, University of Toronto, Canada; Department of Clinical Biochemistry, University Health Network, Toronto, ON, Canada. 2. Department of Clinical Biochemistry, University Health Network, Toronto, ON, Canada. 3. Department of Laboratory Medicine and Pathobiology, University of Toronto, Canada; Department of Clinical Biochemistry, University Health Network, Toronto, ON, Canada. Electronic address: Dr.Ivan.Blasutig@uhn.ca.
Abstract
OBJECTIVES: To evaluate the Siemens N-latex kappa free light chain (κFLC) and lambda FLC (λFLC) assays on the BNII nephelometer and assess agreement with The Binding Site Freelite FLC assays on the SPAPlus. DESIGN AND METHODS: Over 180 patient serum samples from routine analysis of κFLC and λFLC measured by the Freelite assay were collected for the study and measured with the N-latex κFLC and λFLC assays to assess precision, linearity, method comparison and dilutional effects. RESULTS: Complex precision showed coefficients of variation of 4.8-7.2% for the κFLC assay and 3.6-6.0% for the λFLC assay. Linearity assessment showed both assays were linear (κFLC, y=1.00x-0.09 and λFLC, y=1.050x-1.252). Qualitative method comparison showed 87.9% (116/132) agreement and Cohen's kappa of 80.4% between the κFLC assays and 72.6% (98/135) agreement and Cohen's kappa of 55.4% for the λFLC assays. Quantitative method comparison for κFLC<150mg/L was y=0.92x+2.21, R=0.661 and for λFLC<150mg/L was y=7.90x-137.96, R=0.526. Dilutional effects including antigen excess and non-linearity were also examined. CONCLUSIONS: The N-latex assay showed good precision and linearity with reasonable agreement to the Freelite assay. However, the assays should not be used interchangeably to monitor patients.
OBJECTIVES: To evaluate the Siemens N-latex kappa free light chain (κFLC) and lambda FLC (λFLC) assays on the BNII nephelometer and assess agreement with The Binding Site Freelite FLC assays on the SPAPlus. DESIGN AND METHODS: Over 180 patient serum samples from routine analysis of κFLC and λFLC measured by the Freelite assay were collected for the study and measured with the N-latex κFLC and λFLC assays to assess precision, linearity, method comparison and dilutional effects. RESULTS: Complex precision showed coefficients of variation of 4.8-7.2% for the κFLC assay and 3.6-6.0% for the λFLC assay. Linearity assessment showed both assays were linear (κFLC, y=1.00x-0.09 and λFLC, y=1.050x-1.252). Qualitative method comparison showed 87.9% (116/132) agreement and Cohen's kappa of 80.4% between the κFLC assays and 72.6% (98/135) agreement and Cohen's kappa of 55.4% for the λFLC assays. Quantitative method comparison for κFLC<150mg/L was y=0.92x+2.21, R=0.661 and for λFLC<150mg/L was y=7.90x-137.96, R=0.526. Dilutional effects including antigen excess and non-linearity were also examined. CONCLUSIONS: The N-latex assay showed good precision and linearity with reasonable agreement to the Freelite assay. However, the assays should not be used interchangeably to monitor patients.