BACKGROUND & AIMS:
:The usual specimens submitted by a medical examiner for toxicological analysis include blood, urine, bile, vitreous humor, stomach contents, and solid-organ tissue. The detection of drugs in these specimens typically involves a combination of techniques including colorimetry, immunoassay, and gas chromatography. Although many laboratories rely principally on urine for the detection of drugs of abuse by immunoassay, these assays may be applied to other specimen types. An evaluation of Microgenics Corporation's cloned enzyme donor immunoassay (CEDIA) was conducted in order to evaluate its use in the detection of cocaine/cocaine metabolites in vitreous humor specimens. During a 14-month period, 392 vitreous humor specimens were analyzed by the CEDIA DAU Cocaine assay. Instrument parameters were set according to published manufacturer's guidelines. All presumptive positive immunoassay results prompted confirmatory testing and quantitation by gas chromatography-mass spectrometry (GC-MS) of other specimens including blood. Vitreous humor specimens were not tested by GC-MS. Using a approximately 100-ng/mL cutoff, the CEDIA assay produced 23 presumptive positive results, 22 of which were confirmed by GC-MS. The only specimen which could not be confirmed, elicited an immunoassay screen value near the cutoff limit. Routine analysis of blood, urine, bile, and/or bladder wash specimens by gas chromatography-nitrogen phosphorus detection revealed the presence of cocaine/cocaine metabolites in only 7 (31.8%) of the 22 confirmed cases. The concentration ranges of cocaine and benzoylecgonine in the blood specimens were none detected to 337 ng/mL and 17 to 8598 ng/mL, respectively. Cocaethylene was not detected in these cases. Analysis of vitreous humor specimens by CEDIA improved the detection rate of cocaine/cocaine metabolites by 0.7% in the cases submitted to our laboratory during the 14-month period.
背景与目标:
:由体检医师提交的用于毒理学分析的常规标本包括血液,尿液,胆汁,玻璃体液,胃内容物和实体器官组织。这些标本中的药物检测通常涉及多种技术的组合,包括比色法,免疫测定和气相色谱法。尽管许多实验室主要依靠尿液通过免疫测定法检测滥用药物,但这些测定法也可以应用于其他类型的标本。为了评估其在玻璃体液标本中可卡因/可卡因代谢产物检测中的用途,对Microgenics公司的克隆酶供体免疫测定法(CEDIA)进行了评估。在14个月内,通过CEDIA DAU可卡因分析法分析了392具玻璃体液标本。仪器参数是根据已发布的制造商指南进行设置的。所有推定的阳性免疫测定结果均提示通过气相色谱-质谱(GC-MS)对包括血液在内的其他标本进行确认性测试和定量。玻璃体液标本未经GC-MS检测。使用大约100 ng / mL的临界值,CEDIA分析产生了23个推测阳性结果,其中22个通过GC-MS确认。唯一无法确认的标本在临界值附近引发了免疫分析筛选值。通过气相色谱-氮磷检测对血液,尿液,胆汁和/或膀胱洗涤标本进行常规分析,结果表明,在22例确诊病例中,仅7例(31.8%)存在可卡因/可卡因代谢产物。没有检测到血液样本中可卡因和苯甲酰芽子碱的浓度范围分别为337 ng / mL和17至8598 ng / mL。在这些情况下未检测到可口乙烯。通过CEDIA对玻璃体液标本进行分析,在14个月内提交给我们实验室的病例中,可卡因/可卡因代谢物的检出率提高了0.7%。