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La Rivista Italiana della Medicina di Laboratorio 2019 Giugno;15(2):132-9

DOI: 10.23736/S1825-859X.19.00016-1

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: Italian

The issue of false positive and false negative results of troponin. Part I. Critical review of the literature

Francesca VENEZIANI 1 , Massimiliano MANNO 2, Elisabetta STENNER 3, Marco MORETTI 4, Margherita MORANDINI 5, Gianni A. GALLI 6, Maria A. BURGIO 7, Lucia MALLOGGI 8, Giulio MARINO 9, Dina DI MARIA 10, Deborah MAZZEI 8, Daniela RUBIN 11, Matteo CASSIN 12, Alessio GAMBONI 13, Piero CAPPELLETTI 14, a nome del Gruppo di Studio sui Marcatori Miocardici (GdS MM) della Società Italiana di Patologia Clinica e Medicina di Laboratorio (SIPMeL)

1 SOS Laboratorio Analisi, Ospedale S. Maria Nuova, USL Centro Toscana, Firenze, Italia; 2 Laboratorio Analisi, Città di Lecce Hospital-GVM Care&Research, Lecce, Italia; 3 Struttura Complessa di Patologia Clinica, ASUITS, Trieste, Italia; 4 Dipartimento di Patologia Clinica, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italia; 5 Struttura Complessa Laboratorio Analisi, AAS5, Pordenone, Italia; 6 Estote Misericordes, Firenze, Italia; 7 Dipartimento di Patologia Clinica, Ospedale Barone Lombardo, Canicattì, Agrigento, Italia; 8 Laboratorio Analisi, Azienda Ospedaliero Universitaria di Pisa, Pisa, Italia; 9 Laboratorio Analisi, AUSL Bologna, Vergato, Bologna, Italia; 10 Laboratorio Analisi Polimedica, Ravanusa, Agrigento, Italia; 11 Laboratorio Analisi AULSS2, Conegliano Veneto, Treviso, Italia; 12 Dipartimento di Cardiologia, Casa di Cura San Giorgio, Pordenone, Italia; 13 Unità di Medicina d’Urgenza, ASL2 Foligno, Perugia, Italia; 14 SIPMeL, Castelfranco Veneto, Treviso, Italia



BACKGROUND: The issue of false positive (FP) and false negative (FN) results of troponin (cTn) continues also in the era of high sensitivity troponin (hs cTn). The aim of the present work was a critical review of literature to understand the level of awareness of the issue of analytical interferences of cTn methods and the availability of indications for the prevention and the solution of the problem.
METHODS: Researches were conducted on PubMed with the terms “false positive”, “false negative” “troponin” “cTn” for identifying specific literature on analytical interferences of cTn methods, and for a useful classification of FP/FN and recommendations for their prevention and solution.
RESULTS: One hundred and six articles from 279 selected by PubMed focused on analytical interferences of cTn, 46 in the last five years i.e. in the hs-cTn era. From reviews of literature and some selected articles, a reasoned list of causes of FP/FN of cTn was defined, considering preanalytical (patient and phlebotomy) and the analytical (instrument, method, analyte, sample) phases.
CONCLUSIONS: In the scientific literature several articles and some reviews exist about FP/FN of cTn. Nevertheless, in our opinion, robust and exhaustive recommendations for the everyday laboratory practice are still lacking.


KEY WORDS: Troponin; False positive reactions; False negative reactions

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