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Clinical Chemistry 47: 1405-1409, 2001;
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(Clinical Chemistry. 2001;47:1405-1409.)
© 2001 American Association for Clinical Chemistry, Inc.

Articles

Intermethod Discordance for {alpha}-Fetoprotein Measurements in Fanconi Anemia

Bruno Cassinat1a, Diane Darsin1, Philippe Guardiola2, Marie-Elisabeth Toubert1, Jean-Didier Rain1, Eliane Gluckman2 and Marie-Hélène Schlageter1

1 Nuclear Medicine Department and
2 Hematology:Bone Marrow Transplantation Department, Assistance Publique-Hôpitaux de Paris, Saint-Louis Hospital, 75010 Paris, France.

aAddress correspondence to this author at: Service de Médecine Nucléaire, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France. Fax 33-1-42-49-94-05; e-mail cassinat{at}chu-stlouis.fr.

Background: The significantly higher serum {alpha}-fetoprotein (AFP) in patients with Fanconi anemia (FA) than in non-FA aplastic patients has potential diagnostic utility, but the increase is method-dependent. The aim of this study was to compare five AFP assays on FA and non-FA samples and to investigate possible explanations for FA-specific discrepancies.

Methods: Two methods available in our laboratory (Kryptor and IMx) were compared on 59 FA and 27 non-FA patient samples. Kryptor, Immulite, Elecsys, Immuno-I, and Elsa-2 methods were then compared on 14 FA and 14 non-FA patient samples. The AFP glycosylation profile was analyzed by electrophoretic separation in a lectin-containing gel.

Results: With all six methods, AFP values were significantly higher in FA than in non-FA patients, but the diagnostic precision and optimal cutoff values varied. Indeed, two methods reached 100% sensitivity and specificity, but in other methods, one or both of these parameters were significantly <100%. Neither heterophilic antibodies nor a specific glycosylation profile was detected in FA samples.

Conclusions: AFP results are method-dependent in FA. New methods must be evaluated before use in differential diagnosis of aplastic patients.




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A. Shimamura, R. M. de Oca, J. L. Svenson, N. Haining, L. A. Moreau, D. G. Nathan, and A. D. D'Andrea
A novel diagnostic screen for defects in the Fanconi anemia pathway
Blood, December 15, 2002; 100(13): 4649 - 4654.
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