i-CHROMATM PSA Boditech Med Inc. i-CHROMATM PSA biotin labeled BSA, gelatin as a stabilizer, and sodium azide as a preservative in PBS. ImmunoAssay for Quantitative Measurement of PSA in WARNINGS AND PRECAUTIONS Human Whole blood / Serum / Plasma with the i- • IVD For In Vitro Diagnostic Use. CHROMATM Reader system • Carefully follow the instructions and procedures described in this insert. REF Catalog No. i-CHROMATM PSA-25 • Don’t use the Test Device if its lot number shown on the pouch does not agree with that on the ID chip. INTENDED USE i-CHROMA PSA along with i-CHROMATM Reader is a test for the total PSA (tPSA) concentration in the Whole blood/serum/plasma/whole blood1 utilizing fluorescence immunoassay. The test is used as an aid in prescreening and therapeutic evaluation of prostate cancer patients. • i-CHROMATM PSA works only with i-CHROMATM Reader. Tests should be applied by trained personnel working in facilities where the sample(s) is taken by qualified individuals. • LOT Neither interchange materials from different product lots nor use beyond the expiration date. The use of medical device beyond expiration date may affect the test result. • i-CHROMATM PSA should remain in its original sealed pouch until ready to use. Do not use the Test Device if the pouch should be damaged or the seal broken. Discard after single use. INTRODUCTION Prostate specific antigen (PSA) is a neutral serine protease with chymotrypsin-like activity and composed of a single polypeptide chain of 237 amino acids. It is an intracellular glycoprotein containing 7-8% carbohydrate as a single N-linked oligosaccharide side chain, and has a molecular weight of approximately 33 KDa. PSA is synthesized by the glandular epithelium of the prostate and present in benign hyperplastic and malignant prostatic tissue, in metastatic prostatic carcinoma, in prostatic fluid, and seminal plasma. Low levels of PSA are found in the blood of normal male as a result of leakage of the antigen from the prostate gland into circulation. The elevated levels of PSA in the blood are associated with prostatic pathology, including prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. i-CHROMATM PSA quantitatively measures the total PSA concentration in the human whole blood/serum/plasma. • i-CHROMATM PSA and the reader should be used away from vibration and magnetic field. During normal usage, iCHROMATM Reader may produce minute vibration, which should be regarded as normal. • Use separate clean pipette tips and sample vials for different specimens. Pipette tips and sample vials should be used for one specimen only. Discard after single use. • Urine specimens, used test devices, pipette tips and sample vials are potentially infectious. Proper laboratory safety techniques, handling and disposal methods should be followed in accordance with standard procedures and relevant regulations observed by microbiological hazard materials. PRINCIPLE The test uses the sandwich immune-detection method, such that the detector antibody in the buffer binds to the PSA/PSA complex in the serum or the plasma sample and antigen-antibody complexes are captured to the antibody that has been immobilized on the test strip as the sample mixture migrates through the nitrocelluose matrix. The more PSA antigen in the blood, the more antigenantibody complexes accumulates on the test strip. The signal intensity of fluorescence on the detector antibody reflects the amount of the antigen captured and is processed by i-CHROMATM Reader to present the PSA concentration in the specimen. The working range of i-CHROMATM PSA is 0.1-100 ng/ml(in case of whole blood, 0.5-100 ng/ml) • i-CHROMA PSA should not be used as absolute evidence for the prostate cancer. The results should be interpreted by a physician along with clinical findings and other laboratory test results. • The test will be applied on a routine basis and not in emergency situations. • Do not smoke, eat, or drink in areas in which specimens or kit reagents are handled. STORAGE AND STABILITY * Reference Value: 4 ng/mL COMPOSITION OF REAGENTS i-CHROMATM PSA consists of the Test Device, ID Chip, and Detection Buffer. The Test Device is individually sealed with a desiccant in an aluminum pouch, and the Detection Buffer is predispensed individually in a tube and a the bottle containing these tubes is delivered separately in a Styrofoam box filled with ice packs. The Test Device contains a test strip on which the mouse antiPSA antibody and streptavidin have been immobilized on the test and on the control line, respectively. The Detection Buffer, pre-dispensed in a tube, contains fluorescence-labeled anti-human PSA antibody, fluorescence- Rev. 09_ 101217_S Store the Detection Buffer in a refrigerator at 2° - 8°C. The Detection Buffer is stable up to 20 months if stored according to this guide line. Once removed from the refrigerator, allow 30 minutes for the Detection Buffer to reach the room temperature before testing. Store i-CHROMATM PSA at 4°-30°C in its sealed pouch. i-CHROMATM PSA is stable for 20 months (while in the sealed pouch) if stored at 4°-30°C. If stored in a refrigerator, allow a minimum of 30 minutes for the Test Device and the Detection Buffer to reach the room temperature with the test device remaining in the sealed pouch. Enjoy Your Life! i-CHROMATM PSA Boditech Med Inc. Do not remove the test device from the pouch until ready to use. The test device should be used within 3 minutes after opening the pouch. The storage and shipping of Test Kit should be complied as indicated in this insert. However, it is remotely possible that some part of the Test Kit may be affected by the stability problems. SAMPLE COLLECTION AND PREPARATION The test can be performed with either the whole blood or serum or the plasma. For the serum sample, collect the blood in a tube without an anticoagulant and allow it to clot. Remove the serum from the clot as soon as possible to avoid hemolysis. For the plasma sample, collect the blood in a tube treated with EDTA. Anticoagulants other than EDTA have not been evaluated. If testing cannot be conducted within an hour after preparation of specimen, the serum/plasma should be stored at -20o C. The specimen must be at room temperature and be homogeneous for testing. Frozen specimens must be completely defrosted, thoroughly mixed and brought to the room temperature prior to testing. If specimens are to be shipped, they should be packed in compliance with standing local regulations. It is recommended to avoid using severely hemolyzed specimens whenever possible. If a specimen appears to be severely hemolyzed, looking translucent, another specimen should be obtained. MATERIALS PROVIDED Boditech Med Incorporated i-CHROMATM PSA Catalog REF Catalog No. i-CHROMATM PSA -25 7. or more. Take 75 µL of the sample mixture and load it onto the sample well of the Test Device. Load the Test Device into i-CHROMATM Reader. Make sure direction of Test Device and push the device back all the way. Instrument will automatically scan the Test Device after 15min. Read the results on the display screen of i-CHROMATM Reader. 8. Refer to i-CHROMATM Reader Operation Manual for the complete instructions on use of the Test. REF Catalog No. FR- 203 RESULT i-CHROMATM Reader calculates PSA concentration automatically and displays the result on the LCD in units of ng/mL. For further information, refer to the Operation Manual for i-CHROMATM Reader. Quality Control A quality control test using commercially available controls should be performed as a part of good testing practice, to confirm the expected QC results, to confirm the validity of the assay and to assure the accuracy of patient results. Controls from Abbott-AxSYM are recommended. A quality control test should be performed at regular intervals, and before using a new kit with patient specimens. QC specimens should also be run whenever there arises any questions concerning the validity of results obtained. Upon confirmation of the expected results, the test device is ready for use with patient specimens. Control standards are not provided with this test kit. For information about obtaining the controls, contact Boditech Med Incorporated’s Technical Services for assistance. Procedure Control Each i-CHROMATM PSA Test Device contains internal control that satisfies routine quality control requirements. This internal control is performed each time a patient sample is tested. This control indicates that the test device was inserted and read properly by i-CHROMATM Reader. An invalid result from the internal control causes an error message on i-CHROMA Reader, indicating the need for intervention from the user. Box contains: Test Devices Detection Buffer ID Chip Insert 6. x 25 x 25 x1 x1 MATERIALS REQUIRED BUT NOT PROVIDED i-CHROMATM Reader REF Catalog No. RF-203 Thermal Printer (optimal) Transfer pipette (75µL, 30 µL volume) LIMITATIONS OF THE PROCEDURE • Results of i-CHROMATM PSA should be evaluated with all clinical and laboratory data available. If PSA results should not agree with the clinical evaluation, additional tests should be performed. PROCEDURE •Schematic of the Test Device window 1. 2. 3. 4. 5. sample well Set a Test Device on a dust-free clean place. Check/insert ID Chip onto the instrument. Make sure that the Test Device lot # agrees with ID Chip #. Take one tube of Detection Buffer from the refrigerator and leave it at room temperature for 30 min or longer. Draw 75ul of serum / plasma with a transfer pipette and add it to the tube containing the Detection Buffer. Close the Detection Buffer lid and mix the specimen thoroughly with Detection Buffer by shaking the tube 10 times Rev. 09_ 101217_S • The false positive results include cross-reactions with some components of the serum from individual to antibodies; and nonspecific adhesion of some components in human blood that have similar epitopes to capture and detector antibodies. In the case of false negative results, the most common factors are: nonresponsiveness of the antigen to the antibodies by certain unknown components masking epitopes, such that antigen cannot be seen by the antibodies; instability of PSA antigen, resulting in degradation with time and, or temperature, such that they become no longer recognizable by antibodies; and other degraded test components. The effectiveness of the test is highly dependent on storage of kits and sample specimens. It is of critical importance to store them at optimal conditions. • Plasma using anticoagulants (e.g. heparin or citrate) other than EDTA has not been evaluated in i-CHROMATM PSA and thus should not be used. Enjoy Your Life! i-CHROMATM PSA Boditech Med Inc. 2. Analytical Sensitivity i-CHROMA PSA was evaluated for the limit of detection. Three different lots of Test Devices were evaluated with 10 runs of each lot. The minimum detection limit was defined as +3SD over result from null specimens. The limit of PSA in iCHROMA PSA was determined to be 0.08ng/ml. Specificity Other bio-molecules, such as Hb, CEA, AFP, ALP, CRP, Troponin I, CK-MB- Myoglobin, and Albumin were added to test specimen with much higher level than their physiological level in normal blood. There was no significant interference with the PSA measurement, nor was their any significant assay cross-reactivity with those bio-molecules tested. 3. Precision Intra-assay precision Serum/Plasma Sample Mean SD CV (ng/ml) 0.1 0.11 0.01 7.22 0.5 0.50 0.02 4.12 1 1.04 0.06 5.80 2 2.07 0.06 3.01 4 3.99 0.09 2.36 25 24.72 0.81 3.29 Inter-assay precision Serum/Plasma Sample Mean SD CV (ng/ml) 0.1 0.10 0.01 5.48 0.5 0.50 0.02 3.30 1 1.04 0.06 6.06 2 2.08 0.04 2.05 4 3.95 0.12 3.05 25 26.14 0.81 3.11 Whole blood Mean SD CV 0.06 0.53 1.00 2.03 4.01 26.14 0.05 0.08 0.12 0.07 0.15 0.84 81.99 15.15 11.60 3.66 3.66 3.22 Mean SD CV 0.06 0.53 1.02 2.02 4.04 26.14 0.05 0.10 0.11 0.08 0.17 1.25 75.09 18.18 10.48 4.12 4.22 4.77 50 i-Chroma , serum [ng/ml] N = 100 R = 0.98857 30 20 10 0 0 10 20 30 i-Chroma , whole blood[ng/ml] Rev. 09_ 101217_S 40 50 N = 100 R = 0.98732 40 30 20 10 0 0 10 20 30 40 50 PSA serum [ng/ml] The correlation performed on whole blood vs. serum and Serum vs. Plasma (EDTA) were R=0.989 and 0.987, respectively. 5. Comparability Total PSA concentrations of 150 clinical specimens were quantified with i-CHROMATM PSA and with Abbott AXSYM automatic analyzer according to the established standard test procedure. Test results were compared and their compatibility was investigated with the linear regression and the correlation coefficient (R). The linear regression and the correlation coefficient were Y=0.98X-0.34 and R=0.99 respectively. 50 40 Whole blood 4. Precision Correlation of Whole Blood vs. Serum vs. Plasma 40 50 PSA plasma(EDTA) [ng/ml] Performance Characteristics 1. 60 BTF-PSA[ng/ml] • Other factors may interfere with the performance of i-CHROMA TM PSA and may cause erroneous results. These include technical or procedural errors, as well as additional substances in blood specimens. Y = 0.982X-0.33867 SD = 1.46 R = 0.99352 30 20 10 0 0 10 20 30 40 50 Abbott AXSYM[ng/ml] REFERENCES 1. Brooks DE, Devine DV, Harris PC, et al. RAMP(TM): A rapid, quantitative whole blood immunochromatographic platform for point-ofcare testing. Clin. Chem. 1999; 45:1676-1678. 2. Jung K, Elgeti U, Lein M, et al. Ratio of Free or Complexed Prostatespecific Antigen to Total PSA: Which Ratio Improves Differentiation between Benign Prostatic Hyperplasia and Prostate Cancer? Clin. Chem. 2000; 46(1): 55-62. 3. Allard WJ, Zhou Z, Yueng KK. Novel immunoassay for the measurement of complexed prostate-specific antigen in serum. Clin. Chem. 1998; 44(6): 1216-1223. 4. Junker R, Brandt B, Zechel C, and Assmann G. Comparison of prostatespecific antigen (PSA) measured by four combinations of free PSA and total PSA assays. Clin. Chem. 1997; 43(9): 1588-1594. 5. Cheli CD, Marcus M, Levine J, et al. Variation on the Quantitation of Prostate-specific Antigen in Reference Material: Differences in Commercial Immunoassays. Clin. Chem. 1998; 44:1551-1553. 6. Kim BC, Jeong JH, Jeong DS, Choi EY, Kim JH, Nahm, KB. Simplified laser fluorescence scanner for proteomics studies and early cancer diagnosis. SPIE Proceedings 2002;4916:103-108. 7. Woolf SH, Rothemich SF. SCREENING FOR PROSTATE CANCER: The Roles of Science, Policy, and Opinion in determining what is best for Enjoy Your Life! i-CHROMATM PSA Boditech Med Inc. Patients. Annu. Rev. Med. 1999; 50:207-521. 8. Wan XS, Xu YA, Ware JH, and Kennedy AR. Three immunoassays based on monoclonal antibodies specific for prostate specific antigen (PSA), alpha-1-antichymotrypsin (ACT), and the PSA-ACT complex. Prostate 2003; 56:131-141. 9. Jung K, Brux B, Lein M, et al. Molecular Forms of Prostate-specific Antigen in Malignant and Benign Prostatic Tissue: Biochemical and Diagnostic Implications. Clin. Chem. 2000; 46(1): 47-54. 10. Frankel S, Smith GD, Donovan J, Neal D. Screening for prostate cancer. Lancet 2003; 361:1122-1128. 11. Jung K, Klinggr P, Brux B, et al. Preanalytical Determinants of Total and Free Prostate-Specific Antigen and Their Ratio: Blood Collection and Storage Conditions. Clin. Chem. 1998; 44:685-688. Bodtech Med Inc.’s express and implied warranties (including implied warranties of merchantability and fitness) are conditional upon observance of Boditech Med’s published directions with respect to the use of Boditech Med’s products. For Technical Assistance call Boditech Med Inc.’s Technical Services at Tel: +82 (33) 243-1400 E-mail: [email protected] Boditech Med Incorporated 1144-2 Geoduri Dongnaemyeon, Chuncheon, Gangwondo 200-883 Republic of Korea Tel: +82 (33) 243-1400 Fax: +82 (33) 243-9373 www.boditech.co.kr EU Representative: Jai Jun Choung, Ph.D. Eu Biotech Development Ltd. 81 Oxford Street, LONDON, W1D 2EU United Kingdom Tel: +44 207 903 5441 Fax: +44 207 903 5333 E-Mail: [email protected] i-CHROMATM is registered trademarks of Boditech Med Incorporated. Revision No: 09 Date of last revision: December 17, 2010. 0123 Rev. 09_ 101217_S Enjoy Your Life!
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