Molecular Dx Significance 7/10

Preanalytical Best Practices for LC-MS Analysis of Blood Specimens

Preanalytical variables including tube type, additives, hemolysis, storage conditions, and freeze-thaw cycles can critically compromise LC-MS test results yet are often underappreciated. This review systematically addresses each variable and provides practical recommendations: prompt centrifugation, appropriate tube selection, bacteriostatic preservatives, sample enrichment and purification, rejection of unsuitable specimens, and immediate analysis or storage at -70 degrees C. As LC-MS adoption accelerates in clinical laboratories, standardised preanalytical protocols are essential for reliable proteomics and metabolomics results.

The original study

Preanalytical variables for liquid chromatography-mass spectrometry (LC-MS) analysis of human blood specimens.

Authors
Salvagno GL, Danese E, Lippi G
Journal
Clinical biochemistry
Type
Journal Article, Review
PMID
28433611
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Original abstract

The use of liquid chromatography-mass spectrometry (LC-MS) for both diagnostics and research purposes is rapidly growing in clinical laboratories. As for more conventional areas of in vitro diagnostic testing, many preanalytical variables have an impact on these techniques and may hence jeopardize the quality of tests results. The leading preanalytical variables include patient preparation, the nature of the blood collection tubes and additives, interference from spurious hemolysis, sample handling and management, composition of blood tubes, contamination, as well as storage conditions. Therefore, the aim of this article is provide a narrative overview about the leading preanalytical issues which may ultimately influence LC-MS testing of human blood samples, and provide tentative indications, as for current evidence, about optimal preanalytical management of blood samples for proteomics and metabolomics studies. These general recommendations entail pre-storage centrifugation, use of appropriate tubes and additives, addition of bacteriostatic preservatives, enrichment and purification of samples, elimination of unsuitable specimens, rapid analysis or immediate storage at -70°C, and avoidance of analyzing frozen-thawed specimens.