CC BY-NC-ND 4.0 · J Lab Physicians 2022; 14(01): 011-015
DOI: 10.1055/s-0041-1733817
Original Article

An Immunoassay for Human Chorionic Gonadotropin in Cerebrospinal Fluid: Validation of a Modified-Approved Method for Accreditation by the College of American Pathologists

Yao Hu*
1   Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Jiajin Ni*
2   Department of Nursing, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Huating Zhang
1   Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Wenqing Wu
1   Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Yanwen Chen
1   Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Ming Guan
1   Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
› Author Affiliations
Funding This study was supported by grants from the Shanghai Medical and Health Development Foundation.


Background Human chorionic gonadotropin (hCG) detection in cerebrospinal fluid (CSF) can provide additional value in the diagnosis of germinoma. However, matrix effects can influence the results when alternative sample types are used. Therefore, modified-cleared/approved methods, which are standard methods used outside their intended scope, are of interest. The aim of the present study was to establish a model to validate modified-approved methods in agreement with the College of American Pathologists (CAP) accreditation requirements.

Methods Concentrations of hCG in CSF were determined by means of electrochemiluminescence immunoassay using a Roche Cobas e 602 immunoassay analyzer. Based on the intended use, the following performance characteristics were evaluated: precision, the limit of quantitation (LoQ), and the analytical measurement range (AMR). The reference interval (RI) was also established. For the clinical application study, CSF and serum hCG were measured in 10 patients diagnosed with germinoma.

Results The intra- and inter-assay precisions at two levels (10, 250 IU/L) were 0.64 and 0.57% and 4.26 and 3.54%, respectively. The LoQ for hCG was determined to be 0.25 IU/L. The AMR was set from 0.2 to 1,200 IU/L. The RI for hCG in CSF was below 0.40 IU/L. The CSF hCG levels of 10 patients were all above 0.4 IU/L before therapy.

Conclusion Modified-approved methods were validated and showed that the quality specifications of the medical laboratory have a positive value in the clinical context. The illustration of quantification of hCG in CSF resulted in compliance with the CAP accreditation requirements.

Authors' Contributions

All authors have accepted the responsibility for the entire content of this submitted manuscript and approved submission.

Ethics Approval

This study was approved by the Ethics Committee of Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China (protocol KY-2016–395). All clinical investigations were conducted according to the principles expressed in the Declaration of Helsinki.

* Yao Hu and Jiajin Ni contributed equally to this work.

Publication History

Article published online:
08 September 2021

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