临床质谱实验室发展中的机遇与挑战

Development of clinical mass spectrometry laboratories:opportunities and challenges

质谱技术凭借其高灵敏度、高特异性、可同时检测多个化合物等优势,备受临床检验专家的关注并广泛应用于临床检验实验室。近年来,质谱技术在病原微生物鉴定,微量元素及重金属、小分子激素、维生素、氨基酸、多肽和蛋白质的检测,治疗药物监测以及中毒物质筛查等领域不断取得重要成果。为深入探讨质谱技术进入临床实验室所带来的机遇和挑战,中华检验医学杂志特邀来自检验医学领域的知名专家,围绕质谱技术在临床实验室中的定位、质谱技术对临床实验室的发展和改善、质谱检测结果解读面临的挑战、临床质谱实验室运营管理面临的挑战以及临床质谱实验室改进方法等议题发表他们的经验和看法。专家们一致认为,质谱技术的引入为临床实验室和科研带来了新的发展方向和机遇,同时也面临样本前处理难度大、质谱技术成本高且操作复杂、数据处理和解读复杂、标准和规范的缺乏及质谱收费问题等一系列挑战。

Clinical application of mass spectrometry technology has attracted the attention of clinical laboratory experts due to its high sensitivity,high specificity,and capacities of simultaneous detection of multiple compounds.In recent years,mass spectrometry technology has made significant achievements in the fields of identification of pathogenic microorganism,detection of trace elements and heavy metals,small molecule hormones,vitamins,amino acids,peptides and proteins,as well as therapeutic drug monitoring(TDM)and poisoning drugs screening.In order to further clarify the opportunities and challenges brought by this complex mass spectrometry technology in the field of clinical laboratory,the Chinese Journal of Laboratory Medicine invited experts and scholars of laboratory medicine to share their experience and opinions on related items focusing on the positioning of mass spectrometry technology in the clinical laboratory,the development and improvement of the clinical laboratory by mass spectrometry technology,the challenges of interpreting mass spectrometry test results,the challenges of operating and managing clinical mass spectrometry laboratories,and ways of improving the application of clinical mass spectrometry laboratories with this technology.Agreement was achieved in that the introduction of mass spectrometry technology into the clinical laboratory could bring new directions and opportunities for clinical testing and research,and also is associated with a series of challenges such as the difficulty of sample pretreatment,the high cost and complexity of mass spectrometry technology,the complexity of data processing and interpretation,the lack of standards and norms,and the issue of determining the price of mass spectrometry examinations.