Valutazione dell'impatto delle raccomandazioni del Gruppo di Studio SIBioC Proteine sull'operatività dei laboratori italiani

Protein diagnostics is central in the management of subjects with monoclonal gammopathy. Laboratory should provide the most useful information to ensure the best patient outcome. To assess if recommendations issued after the 2007 survey have impacted on Italian laboratories contributing to a better harmonization of the post-analytical phase, the SIBioC Proteins Study Group has repeated a similar survey in February 2015. Twenty questions were electronically submitted to all SIBioC members using the software "Survey monkey". 103 responses were collected, corresponding to ∼6% of Italian laboratories. 47% of laboratories add an appropriate comment to the serum protein electrophoresis report when no monoclonal component (MC) is detected (36% in 2007). MC are correctly defined by 63% of the laboratories; however, 11% reports MC as "thickening" or "asymmetry" or "homogeneous peak". These ambiguous terms were used by roughly the same percentage (14%) in 2007. In 2015, the number of laboratories performing a MC typing only when requested by the clinician is reduced by 10% when compared to 2007. In both surveys, the percentage of laboratories performing and reporting the MC quantification is 77%. The worse results were obtained for Bence Jones protein (BJP) determination (not investigated in 2007): only 66% of laboratories utilize the immunofixation to detect the BJP and 57% do not quantify the protein. Although some progresses in harmonization of reporting are observed in CM testing over years, there is still room for significant improvement.