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AFP phosphatase conjugate in PBS buffer. testing will be delayed for more than 72 hours,
Rc TRIS Buffer. samples should be frozen at -20°C or below. Procedure Limitations
Alpha-fetoprotein (CLIA)
Avoid repeated freezing and thawing. This kit is not intended to be used for the risk
The position of the kit components is shown in evaluation of trisomy 21.
Intended Use the following figure:
Procedure The upper limit of the assay is 1210 ng/mL. A
Chemiluminescent immunoassay (CLIA) for sample with AFP concentration lower than the
quantitative determination of alpha-fetoprotein Before loading the reagents into the analyzer for
the first time, gently invert the bottle of upper limit can be quantitatively determined,
(AFP) in serum or plasma while a sample with a concentration higher than
unopened reagents at least 30 times to
resuspend microparticle sediments settled the upper limit will be reported as >1210 ng/mL.
during storage. Visually inspect the bottle to AFP concentration in a sample tested with
Summary
ensure microparticle resuspension. If they various commercial kits can vary due to
Alpha-fetoprotein (AFP) is an embryo-specific differences in test methods, calibration and
remain adhered to the bottle, continue inverting
alpha-globulin. It is a single polypeptide chain reagent specificity. The test results should be
until complete resuspension. If microparticles
glycoprotein with a molecular weight of used along with other data such as symptoms,
are still not resuspended, discard the bottle.
approximately 70,000 Daltons. It is the main results of other tests, clinical history, etc.
protein in fetal circulation as well as albumin. Non-provided Reagents The assay requires 15 μL sample for a single Samples from individuals exposed to mouse
AFP synthesis occurs mainly in the yolk sac, .- AFP Calibrators test. This volume does not include the dead monoclonal antibodies may contain human
liver and gastrointestinal tract of the fetus. It - Tumor Marker Multi Control (L) volume of the sample container. anti-mouse antibody (HAMA). These samples
can be detected in the fetal circulation as early - Tumor Marker Multi Control (H) may show either falsely high or low values with
as 30 days after gestation. It reaches a peak at - Wash Buffer kits using mouse monoclonal antibodies.
about 13 weeks of gestation and gradually - Substrate Solution Calibration However, no obvious interference of HAMA was
declining thereafter. Elevated AFP levels are These reagents are provided separately by The Alpha-fetoprotein (CLIA) kit has been observed in this assay.
found during pregnancy and in several Wiener lab. standardized according to the WHO
malignant diseases. Elevated AFP levels can be international standard for alpha-fetoprotein
detected in about 80% of patients with hepatic (NIBSC code: AFP). Performance
carcinoma and 50% of patients with germ cell Instructions for Use a) Analytical sensitivity: ≤0.5 ng/mL.
tumors. It can also be detected in other patients The reagents are ready to use. The specific information on the master
b) Measuring range: 0.5 to 1210 ng/mL.
with gastrointestinal tumors. AFP synthesis is calibration curve is included in the provided
bidimensional code. It is used together with the c) Specificity:
elevated in liver carcinomas, even though the Warnings calibrators for the calibration of a specific - Hemoglobin up to 500 mg/dL, bilirubin up to
corpus carcinosus were very small. This allows - For "in vitro" diagnostic use.
early AFP detection, in conjunction with some reagent lot. When performing the calibration, 20 mg/dL, triglycerides up to 520 mg/dL, total
- Keep the reagent kit in the upright position to scan the information from the master protein up to 10.0 g/dL, rheumatoid factor up to
other tests. It has also been discovered that AFP ensure no microparticles have been lost prior to calibration curve from the code into the system 1500 IU/mL or antinuclear antibody up to 4000
is elevated in diseases such as acute viral use.
hepatitis, chronic active hepatitis and cirrhosis, first. Then use the calibrators at three levels. IU/L will not interfere with the assay.
- Avoid using reagents from another source. Valid calibration curve is required before any - No significant cross-reactivity was observed
but not as high as in hepatic carcinoma. The - Avoid using reagents after the expiration date.
level of serum AFP in patients with cirrhosis is AFP test. Recalibration is recommended every 4 when the substances listed in the table below
- Do not exchange reagents from different lots. weeks or when a new reagent lot is used, or the were added to the C0 calibrator of AFP
usually between 25 and 200 ng/mL. High level - All patient samples should be handled as if
of serum AFP normally accompanies high levels quality controls are out of the specified range. Calibrators. The results showed no more than
capable of transmitting infection. For detailed instructions on calibration, refer to 2.0 ng/mL in the AFP assay at the levels
of transaminases. If AFP level is high while - Use the reagents keeping the usual work
transaminases level is low, or AFP level is more the analyzer operation manual. indicated below.
precautions in the clinical laboratory.
than 500 ng/mL, the presence of hepatic - All reagents and samples should be discarded
carcinoma is highly possible. Substance Concentration
according to local regulations. Quality Control Method HCG 1000 mIU/mL
Tumor Marker Multi Control (L) and Tumor α-1-acid
Principle Marker Multi Control (H) from Wiener lab. 2 mg/mL
Stability and Storage Instructions glycoprotein
Alpha-fetoprotein (CLIA) is a sandwich The kit is stable at 2-8°C until the expiration Transferrin 400 mg/dL
assay for the quantitative determination of AFP date shown on the box. Calculations α-1-antitrypsin 500 mg/dL
in serum or plasma.
The analyzer automatically calculates the PRL 50,000 mIU/mL
In the first step, sample, paramagnetic
analyte concentration of each sample from the
microparticles coated with anti-AFP antibody Required material (non-provided) master calibration curve read from the code and
and anti-AFP-alkaline phosphatase conjugate - Interference tests were performed with
Wiener lab. CLIA series chemiluminescence a 4-parameter logistic curve fitting (4PLC) with commonly used pharmaceuticals. These
are added to a reaction cuvette. After incubation,
analyzer the relative light units (RLU) generated by the 3 compounds showed less than 10% interference
the sandwich complex formed in the presence of levels of calibrators. The results are shown in
AFP is magnetically captured. Unbound in the AFP assay at the levels indicated below.
ng/mL.
substances are removed by successive washes.
In the second step, the Substrate Solution is Sample Conversion factors: ng/mL x 0.83 = IU/mL Substance Concentration
added to the reaction cuvette. The Serum or plasma IU/mL x 1.21 = ng/mL Acetaminophen 200 μg/mL
chemiluminescent reaction produced by the a) Collection: obtain the sample in the usual Acetylsalicylic acid 0.50 mg/mL
conjugate is measured as relative light units way. Expected Values
(RLU). The amount of AFP present in the sample In a study of a population of 736 healthy Cisplatin 100 μg/mL
b) Additives: when using plasma, the use of Ascorbic acid 1000 μg/mL
is directly proportional to the RLU generated EDTA, sodium heparin or lithium heparin as individuals (345 males and 391 females) the
during the reaction. AFP concentration is anticoagulants is recommended. following reference range was obtained: Cyclophosphamide 25 mg/dL
determined via a calibration curve. Vincristine 70 mg/dL
c) Centrifuge samples and separate serum or
plasma within 2 hours. Category N 97,5% Percentile
Provided Reagents Male 345 < 7.2 ng/mL - Calibrator C0 of AFP Calibrators from Wiener
d) Stability and storage instructions:
lab. was supplemented with other tumor
samples should be tested as soon as Female 391 < 7.4 ng/mL
Paramagnetic microparticles coated markers listed in the following table. No evident
Ra with anti-AFP monoclonal antibody in possible after sample collection. If testing Total 736 < 7.0 ng/mL cross-reactivity was observed, since all results
TRIS buffer. is not completed within 8 hours, samples should were ≤5,0 ng/mL
It is recommended that each laboratory
Rb Monoclonal anti-AFP antibody-alkaline be tightly capped and refrigerated at 2-8°C. If establish its own reference range.
v. 000 UR16/10/11 P/N:046-010069-00(1.0) 1 /2 English-1
Wiener lab.
Obtained - Palomaki GE, Hill LE, Knight GJ, et al. Second
Tumor AFP Acceptance Trimester Maternal Serum Alpha-Fetoprotein Contents
Concentration Cont.
Marker Criteria Levels in Pregnancies Associated with
(ng/ml)
Gastroschisis and Omphalocele. Obstet Gynecol
PSA 100 ng/mL 0.00 1988; 71:906-9.
CA 125 1000 IU/mL 0.01 M SHENZHEN MINDRAY BIO-MEDICAL
CA 15-3 100 IU/mL 0.01 Obtained - Gitlin D, Perricelli A, Gitlin GM. Synthesis of ELECTRONICS CO., LTD.
AFP ≤5.0 a-fetoprotein by liver, yolk sac, and Mindray building. Keji 12th Road South. Hi-tech
CA 19-9 1000 IU/mL 0.00
ng/mL gastrointestinal tract of the human conceptus. Industrial Park.
CEA 1000 ng/mL 0.00 Cancer Res 1972; 32: 979.
FERR 1000 ng/mL 4.61 Manufactured for:
- Nelson LH, Bensen J, Burton BK. Outcomes in Wiener Laboratorios S.A.I.C.
Patients with Unusually High Maternal Serum Riobamba 2944
d) Prozone effect: no prozone effect was Alpha-fetoprotein Levels. Am J Obstet Gynecol 2000 Rosario - Argentina
observed up to 120,000 ng/mL AFP. 1987; 157(3):572–5. http://www.wiener-lab.com
e) Accuracy: A.N.M.A.T. Registered product
A sample of WHO International Standard - Taketa K. Alpha-Fetoprotein in the 1990s. En: Cert. Nº
Alpha-fetoprotein (AFP NIBSC code) with Sell SS. Serological cancer markers. Humana Tech. Dir.: Viviana E. Cétola
defined and traceable value was used to verify Press 1992: 31–46, ISBN: 0-89603-209-4. Biochemist
the accuracy of the assay. The results showed
that the relative deviation was less than ± 10%. - Silver HKB, Gold P, Feder S, Freedman SO,
The results are listed in the following table. Shuster J. Radioimmunoassay for human
alpha-fetoprotein. Proc Natl Acad Sci U.S.A.
1973; 70: 526-30.
Defined
Measured AFP Relative
Sample - Perlin E, Engeler JE, Edson M, Karp D, McIntire
AFP (ng/mL) Deviation
(ng/mL) KR, Waldmann TA. The value of serial
WHO AFP 112.64 116.83 -3.59% measurement of both human chorionic
gonadotropin and alpha- fetoprotein for
monitoring germinal cell tumors. Cancer 1976;
f) Precision: 37: 215-9.
Precision was determined by EP5-A2 Protocol of
the National Committee for Clinical Laboratory - Endo Y, Kanai K, Oda T, Mitamura K, Iino S,
Standards (NCCLS). Two levels of quality Suzuki H. Clinical significance of a-fetoprotein in
control were tested in duplicate in two separate hepatitis and liver cirrhosis. Ann NY Acad Sci
runs per day, for a total of 20 days. 1975; 259: 234.
Composto Concentração
estatísticos obtidos são mostrados na tabela abaixo. M Elaborado por
Acetaminofeno
Ácido acetilsalicí
lico
200 μg/mL
0,50 mg/mL
Intervalo de
Pendent Interseçã
Coeficient
e de
V Uso médico-diagnóstico "in vitro"
concentraçã
Cisplatina 100 ug/mL o (ng/mL)
e o correlaçã i Consultar instrucciones de uso
o
Ácido ascórbico 1000 μg/mL
Ciclofosfamida 25 mg/dL
0,13-1476,15 0,949 0,115 0,996 U Este lado para cima
Vincristina 70 mg/dL
Apresentação
l Limite de temperatura (conservar a)
- O Calibrador C0 de AFP Calibrators da Wiener lab.
foi suplementado com outros marcadores tumorais
- 2 x 50 testes (cód. 1001012) g Número de lote
- 2 x 100 testes (cód. 1001013)
indicados na tabela abaixo. Não foi observada
reatividade cruzada evidente visto que todos os
H Data de validade
resultados foram ≤5,0 ng/mL Referências
h Número de catálogo
- Ruoslahti E, Seppala M. Studies of carcino-fetal
Marcador
Concentração
AFP obtida Critério de proteins: physical and chemical properties of F Risco biológico
tumoral (ng/mL) aceitação human a-fetoprotein. Int. J. Cancer 1971; 7: 218.
PSA 100 ng/mL 0,00 - Palomaki GE, Hill LE, Knight GJ, et al. Second Cont. Conteúdo
CA125 1000 UI/mL 0,01 Trimester Maternal Serum Alpha-Fetoprotein
CA15-3 100 UI/mL 0,01 AFP obtida Levels in Pregnancies Associated with
CA19-9
CEA
1000 UI/mL
1000 ng/mL
0,00
0,00
≤5,0 ng/mL Gastroschisis and Omphalocele. Obstet Gynecol
1988; 71:906-9. M SHENZHEN MINDRAY BIO-MEDICAL
- Gitlin D, Perricelli A, Gitlin GM. Synthesis ELECTRONICS CO., LTD.
FERR 1000 ng/mL 4,61
of a-fetoprotein by liver, yolk sac, and Mindray building. Keji 12th Road South. Hi-tech
gastrointestinal tract of the human conceptus. Industrial Park.
d) Efeito prozona: não foi observado efeito Cancer Res 1972; 32: 979.
Fabricado para:
prozona até120.000 ng/mL de AFP.
- Nelson LH, Bensen J, Burton BK. Outcomes in Wiener Laboratorios S.A.I.C.
Patients with Unusually High Maternal Serum Riobamba 2944
e) Exatidão: Alpha-fetoprotein Levels. Am J Obstet Gynecol 2000 Rosario - Argentina
Uma amostra de Alfafetoproteí na de Padrão 1987; 157(3):572–5. http://www.wiener-lab.com
Internacional da OMS (código NIBSC: AFP) com Producto Autorizado por A.N.M.A.T.
- Taketa K. Alpha-Fetoprotein in the 1990s. Em: Sell
valor rastreável e definido foi utilizado para verificar Cert. Nº
a exatidão deste ensaio. Os resultados mostraram SS. Serological cancer markers. Humana Press Dir. Téc.: Viviana E. Cétola
que o desvio relativo foi inferior a ±10%. Os 1992: 31–46, ISBN: 0-89603-209-4. Bioquí mica
resultados são mostrados na tabela abaixo: - Silver HKB, Gold P, Feder S, Freedman SO,
Shuster J. Radioimmunoassay for human
Desvio alpha-fetoprotein. Proc Natl Acad Sci U.S.A. 1973;
AFP medida AFP definida
Amostra Relativo 70: 526-30.
(ng/mL) (ng/mL)
- Perlin E, Engeler JE, Edson M, Karp D, McIntire KR,
AFP OMS 112,64 116,83 -3,59% Waldmann TA. The value of serial measurement of
both human chorionic gonadotropin and alpha-
f) Precisão: fetoprotein for monitoring germinal cell tumors.
A precisão foi determinada de acordo com o Cancer 1976; 37: 215-9.
Protocolo EP5-A2 do ComitéNacional para Padrões - Endo Y, Kanai K, Oda T, Mitamura K, Iino S, Suzuki
de Laboratório Clínico (NCCLS). Dois níveis de
H. Clinical significance of a-fetoprotein in hepatitis
controles de qualidade foram testados em duplicado
and liver cirrhosis. Ann NY Acad Sci 1975; 259:
em duas séries separadas por dia, por um total de 20
234.
dias
- NCCLS. EP5-A2 Evaluation of precision
performance of quantitative measurement
Valor CV CV
method; approved guideline-second edition.
Amostra médio intra-ensa inter-ensa CV total
2004.
(ng/mL) io io