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CEDIA’s EDDP immunoassay is a cost-effective compliance marker in an opiate dependency program.
44TH ANNUAL CSCC-CAMB-AACC CONFERENCE
serum levels increased after several days of treatment in 74% of the patients. This increase was significant (p ⬍ 0.001; paired Students T test) when patients ingested the full complement of their energy needs. This successful nutritional intervention resulted in a 50% decrease of re-hospitalisation over the three months following discharge. Conclusions: Serum albumin represents a simple and economic way to screen for malnutrition. The significant increase in serum pre-albumin observed after successful nutritional intervention underlines its usefulness as a nutritional marker in a hospital setting.
15 CEDIA’S EDDP IMMUNOASSAY IS A COSTEFFECTIVE COMPLIANCE MARKER IN AN OPIATE DEPENDENCY PROGRAM. Kapur, B.M,1,3,5 Selby, P.,2,4,5 Latowsky, M.,4 Singh, M.1 and Koren, G.4 Canadian Medical Laboratories1, Centre for Addiction and Mental Health2, Dept of Lab Med and Pathobiology3, Depts of Family Medicine4, Faculty of Medicine, University of Toronto, Div. of Clin. Pharm. and Toxicology5, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8 Patients in opiate treatment programs may divert their methadone dose and adulterate their urine to prevent detection. Common adulteration methods are in-vitro addition of methadone or altering urine pH. Excretion of EDDP, the metabolite of methadone, is unaffected by changes in urine pH and is present only if methadone dose was ingested. Most programs test for methadone by immunoassay and EDDP by the more expensive TLC or HPLC. Objective: To evaluate if CEDIA’s EDDP assay can be used as marker of methadone compliance and replace HPLC. Methods: For a period of four weeks urine samples from patients attending two clinics were analysed for pH, creatinine, methadone and EDDP. The latter two by CEDIA immunoassay procedure and HPLC (REMEDiBioRad). To maintain blindness, interpretation of HPLC and CEDIA results were done independently. For the first two weeks both methadone and EDDP results were released to the physicians (SP and LM) and for the following two weeks only EDDP results were released. Results: 225 urine samples representing 85 patients were analysed. 24 were negative for both methadone and EDDP. There was 100% concordance between HPLC and CEDIA immunoassay for both methadone and EDDP assays. One sample with a pH of 7.9 was negative for methadone but positive for EDDP. Conclusion: CEDIA’s EDDP assay is a viable, cheaper method and can replace the HPLC procedure. Analysis of methadone did not enhance the test interpretation and can be eliminated to reduce the cost of testing. 230
16 DRAMATIC OVEREXPRESSION OF THE KALLIKREIN-LIKE GENE 2 (KLK-L2), IN OVARIAN CARCINOMAS Kim, H.,2 Yousef, G.M.,2 Katsaros, D.,3 Diamandis, E.P.1,2 Department of Pathology and Laboratory Medicine1, Mount Sinai Hospital, Toronto, Ontario, Canada, M5G 1X5, Department of Laboratory Medicine and Pathobiology2, University of Toronto, Toronto, Ontario, Canada, M5G 1L5, University of Turin3, Turin, Italy 10126 Objectives: Kallikrein-like gene-2(KLK-L2) is one of the newly identified members of the kallikrein gene family(GeneBank Accession #AF135028). In normal human tissues, KLK-L2 is highly expressed in skin, mammary gland and testis tissues. From the high degree of homology between KLK-L2 and other members of the kallikrein family, we speculated that the KLK-L2 gene product is likely to be a secreted protein. Hence, it would be of great interest to investigate changes in KLK-L2 expression at different points of cancer development, as detection of such changes may be used for diagnosing and monitoring cancer. The current study examines and compares, preliminarily, the expression of KLK-L2 gene transcripts in normal, benign and cancerous human ovarian tissues(n ⫽ 5 per group). Methods: Total RNA was extracted and subsequently used for reverse transcription polymerase chain reaction(RT-PCR). Results: Results were scored as negative, weakly, moderately or highly expressed KLK-L2 mRNA. We found relatively low expression of mRNA in both normal(2 weakly positive signals) and benign tissues(2 weakly positive signals, 1 moderately positive signal). In contrast, the mRNA expression was dramatically elevated in all five cancerous tissues examined (all scored as highly expressed). Conclusion: These data strongly suggest that KLk-l2 is frequently overexpressed in ovarian tumors. In conclusion, KLk-L2 protein may contribute as a new tumor marker for diagnosis and monitoring of ovarian carcinoma. 17 DISCORDANT FREE T3 VALUES ON IMMUNOCHEMISTRY SYSTEMS Krahn, J.,1 and Dent, W.2 Clinical Biochemistry1, St. Boniface General Hospital, 409 Tache Ave., Winnipeg, Manitoba, Canada R2H 2A6, Clinical Chemistry2, Health Sciences Centre, 820 Sherbrook St., Winnipeg, Manitoba, Canada, R3A 1R9 Objective: To determine whether free triiodothyronine (FT3) values generated on the routine instrument (Immuno 1威) in our lab generated results that were inappropriately elevated. Design: All thyroid panels run on our routine analyzer were reviewed for physiological consistency. FT3 values that did not have a good physiological relationship with free thyroxine (FT4) and TSH values were aliquoted and analyzed by an additional 4 methods. These samples were CLINICAL BIOCHEMISTRY, VOLUME 33, APRIL 2000
serum levels increased after several days of treatment in 74% of the patients. This increase was significant (p ⬍ 0.001; paired Students T test) when patients ingested the full complement of their energy needs. This successful nutritional intervention resulted in a 50% decrease of re-hospitalisation over the three months following discharge. Conclusions: Serum albumin represents a simple and economic way to screen for malnutrition. The significant increase in serum pre-albumin observed after successful nutritional intervention underlines its usefulness as a nutritional marker in a hospital setting.
15 CEDIA’S EDDP IMMUNOASSAY IS A COSTEFFECTIVE COMPLIANCE MARKER IN AN OPIATE DEPENDENCY PROGRAM. Kapur, B.M,1,3,5 Selby, P.,2,4,5 Latowsky, M.,4 Singh, M.1 and Koren, G.4 Canadian Medical Laboratories1, Centre for Addiction and Mental Health2, Dept of Lab Med and Pathobiology3, Depts of Family Medicine4, Faculty of Medicine, University of Toronto, Div. of Clin. Pharm. and Toxicology5, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8 Patients in opiate treatment programs may divert their methadone dose and adulterate their urine to prevent detection. Common adulteration methods are in-vitro addition of methadone or altering urine pH. Excretion of EDDP, the metabolite of methadone, is unaffected by changes in urine pH and is present only if methadone dose was ingested. Most programs test for methadone by immunoassay and EDDP by the more expensive TLC or HPLC. Objective: To evaluate if CEDIA’s EDDP assay can be used as marker of methadone compliance and replace HPLC. Methods: For a period of four weeks urine samples from patients attending two clinics were analysed for pH, creatinine, methadone and EDDP. The latter two by CEDIA immunoassay procedure and HPLC (REMEDiBioRad). To maintain blindness, interpretation of HPLC and CEDIA results were done independently. For the first two weeks both methadone and EDDP results were released to the physicians (SP and LM) and for the following two weeks only EDDP results were released. Results: 225 urine samples representing 85 patients were analysed. 24 were negative for both methadone and EDDP. There was 100% concordance between HPLC and CEDIA immunoassay for both methadone and EDDP assays. One sample with a pH of 7.9 was negative for methadone but positive for EDDP. Conclusion: CEDIA’s EDDP assay is a viable, cheaper method and can replace the HPLC procedure. Analysis of methadone did not enhance the test interpretation and can be eliminated to reduce the cost of testing. 230
16 DRAMATIC OVEREXPRESSION OF THE KALLIKREIN-LIKE GENE 2 (KLK-L2), IN OVARIAN CARCINOMAS Kim, H.,2 Yousef, G.M.,2 Katsaros, D.,3 Diamandis, E.P.1,2 Department of Pathology and Laboratory Medicine1, Mount Sinai Hospital, Toronto, Ontario, Canada, M5G 1X5, Department of Laboratory Medicine and Pathobiology2, University of Toronto, Toronto, Ontario, Canada, M5G 1L5, University of Turin3, Turin, Italy 10126 Objectives: Kallikrein-like gene-2(KLK-L2) is one of the newly identified members of the kallikrein gene family(GeneBank Accession #AF135028). In normal human tissues, KLK-L2 is highly expressed in skin, mammary gland and testis tissues. From the high degree of homology between KLK-L2 and other members of the kallikrein family, we speculated that the KLK-L2 gene product is likely to be a secreted protein. Hence, it would be of great interest to investigate changes in KLK-L2 expression at different points of cancer development, as detection of such changes may be used for diagnosing and monitoring cancer. The current study examines and compares, preliminarily, the expression of KLK-L2 gene transcripts in normal, benign and cancerous human ovarian tissues(n ⫽ 5 per group). Methods: Total RNA was extracted and subsequently used for reverse transcription polymerase chain reaction(RT-PCR). Results: Results were scored as negative, weakly, moderately or highly expressed KLK-L2 mRNA. We found relatively low expression of mRNA in both normal(2 weakly positive signals) and benign tissues(2 weakly positive signals, 1 moderately positive signal). In contrast, the mRNA expression was dramatically elevated in all five cancerous tissues examined (all scored as highly expressed). Conclusion: These data strongly suggest that KLk-l2 is frequently overexpressed in ovarian tumors. In conclusion, KLk-L2 protein may contribute as a new tumor marker for diagnosis and monitoring of ovarian carcinoma. 17 DISCORDANT FREE T3 VALUES ON IMMUNOCHEMISTRY SYSTEMS Krahn, J.,1 and Dent, W.2 Clinical Biochemistry1, St. Boniface General Hospital, 409 Tache Ave., Winnipeg, Manitoba, Canada R2H 2A6, Clinical Chemistry2, Health Sciences Centre, 820 Sherbrook St., Winnipeg, Manitoba, Canada, R3A 1R9 Objective: To determine whether free triiodothyronine (FT3) values generated on the routine instrument (Immuno 1威) in our lab generated results that were inappropriately elevated. Design: All thyroid panels run on our routine analyzer were reviewed for physiological consistency. FT3 values that did not have a good physiological relationship with free thyroxine (FT4) and TSH values were aliquoted and analyzed by an additional 4 methods. These samples were CLINICAL BIOCHEMISTRY, VOLUME 33, APRIL 2000