title: Performance comparison of capillary and agarose gel electrophoresis for the identification and characterization of monoclonal immunoglobulins.
abstract: The objective of this study was to compare gel- and capillary-based serum protein electrophoresis methods to identify and characterize monoclonal immunoglobulins (M proteins). Five reviewers interpreted 149 consecutively ordered serum specimens following agarose gel electrophoresis (AGE), capillary electrophoresis (CE), immunofixation electrophoresis (IFE), and subtraction immunotyping (IT). As a screening test for detecting M proteins, AGE and CE displayed similar sensitivity (91% and 92%, respectively). CE was less specific (74%) than AGE (81%). An analysis of interinterpreter agreement revealed that interpretations were more consistent using gel-based methods than capillary-based methods, with 80% of the gel interpretations being in complete (5/5) agreement compared with 67% of the capillary interpretations. After implementing the capillary-based methods, the number of tests per reportable result increased (from 1.58 to 1.73). CE is an analytically suitable alternative to AGE, but laboratories implementing it will need to continue IFE testing to characterize all M proteins detected by CE.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: McCudden
authors.forename: Stephanie P
authors.initials: SP
authors.lastname: Mathews
authors.forename: Shirley A
authors.initials: SA
authors.lastname: Hainsworth
authors.forename: John F
authors.initials: JF
authors.lastname: Chapman
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Hammett-Stabler
authors.forename: Monte S
authors.initials: MS
authors.lastname: Willis
authors.forename: David G
authors.initials: DG
authors.lastname: Grenache
mesh_terms: D000911:Antibodies, Monoclonal / Q000097:blood / Q000302:isolation & purification*; D001797:Blood Protein Electrophoresis / Q000379:methods; D004587:Electrophoresis, Agar Gel; D019075:Electrophoresis, Capillary; D006801:Humans; D010266:Paraproteins / Q000302:isolation & purification*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000911:Antibodies, Monoclonal; D010266:Paraproteins