engleski

ESTABLISHMENT OF THE CORRECT DIAGNOSIS BY CHROMATOGRAPHY AND MASS SPECTROMETRY

During the last few decades chromatographic and mass spectrometry techniques entered clinical diagnostics field. In some instances they replaced exisitng immunoassays or spectrofotometric methods but they also enabled introduction of completely new analytes i.e. diagnostic parameters in clinical practice. Thanks to these techniques even the new clinical entities have been recognized. Almost all types of chromatography and mass spectrometry have been applied in clinical diagnostics. But, HPLC, GCMS and LCMSMS play the most prominent roles in routine use. The main advantages of these analytical techniques over other diagnostic approaches are their sensitivity, selectivity and the substance identification capability. Submicromolar concentrations of different analytes can be easily measured by these approaches. Other techniques already available in clinical laboratories are rarely so sensitive. Numerous interferences present in biological samples are easily recognized and their influence can be eliminated by these techniques. Therefore, different chromatographic and mass spectrometry methods have become reference methods for various diagnostic parameters. Still, these techniques are not widely used in routine. The main limitations are demanding sample preparation and a limited robustness. These properties disable full analytical process automation needed to fulfill ever increasing demands for short turn around times. In instances when high accuracy is not an issue other techniques fill in. But therapeutic drug monitoring, toxicology and forensic pathology, congenital metabolic diseases and endocrinological disorders are clinical fields that take full advantage of chromatography and mass spectrometry. It is expected of these techniques to take a more prominent role in protein diagnostics. Clinical utility, current status and future clinical prospects of chromatography and mass spectrometry will be reviewed through paradigmatic case studies.

laboratory diagnostics; chromatography; mass spectrometry

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