Pancreatic lipase: why laboratory community does not take enough care of this clinically important test?

Sara Pasqualetti; Francesca Borrillo; Leila Rovegno; Mauro Panteghini

doi:10.1515/cclm-2021-0850

Article

Pancreatic lipase: why laboratory community does not take enough care of this clinically important test?

Sara Pasqualetti , Francesca Borrillo , Leila Rovegno and Mauro Panteghini

Published/Copyright: September 17, 2021

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From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 59 Issue 12

Abstract

Although being the recommended laboratory test to diagnose acute pancreatitis, serum pancreatic lipase (LIP) is among the poorly standardized laboratory tests, and laboratory stakeholders often appear to not take enough care of the quality of its measurements. Here we discuss some important issues that, if not correctly managed and solved, make misdiagnosis of acute pancreatitis by using serum LIP a real possibility. First, the current unavailability of a suitable higher-order reference material to be used as common calibrator should be filled up to definitively improve the inter-method bias. Second, knowledge of the analytical characteristics that may explain the defective performance of LIP assays should be deepened. IVD manufacturers should be more explicit in providing this information, including description of their internal protocol for transferring LIP values from internal references to commercial calibrators. Third, recommended models for accurately estimating measurement uncertainty and reliably defining analytical performance specifications for LIP measurements should be applied. Finally, investments considering alternative options for measuring LIP (e.g., targeted to the development of automated LIP immunoassays) should be warranted. All involved stakeholders (standardization bodies, higher-order reference providers, in vitro diagnostics manufacturers, and laboratory professionals) should contribute to fill the existing gap.

Keywords: analytical performance specifications; enzyme activity; measurement uncertainty; metrological traceability; pancreatic lipase; reference limits

Corresponding author: Sara Pasqualetti, Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milano, Italy; and Clinical Pathology Unit, Luigi Sacco University Hospital, via GB Grassi 74, Milan, 20157, Italy, E-mail: sara.pasqualetti@asst-fbf-sacco.it

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Not applicable.
Ethical approval: Not applicable.

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Received: 2021-07-30

Accepted: 2021-08-25

Published Online: 2021-09-17

Published in Print: 2021-11-25

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DOI: doi.org/10.1515/cclm-2021-0850

Keywords for this article

analytical performance specifications; enzyme activity; measurement uncertainty; metrological traceability; pancreatic lipase; reference limits