Sun T, Lien Y Y, Degnan T
Am J Clin Pathol. 1979 Jul;72(1):5-11. doi: 10.1093/ajcp/72.1.5.
Immunofixation electrophoresis and immunoelectrophoresis were compared in 60 samples (51 sera and 9 urines) containing apparently homogenous bands, detected by electrophoresis. To determine the correlation with clinical findings, the patients were divided into three groups: (1) symptomatic with monoclonal immunoelectrophoretic patterns; (2) asymptomatic with monoclonal immunoelectrophoretic patterns; (3) asymptomatic with polyclonal immunoelectrophoretic patterns. The results from immunoelectrophoresis and immunofixation electrophoresis were consistent with each other in all cases of Groups I and III in terms of clonality (i.e., whether monoclonal or polyclonal) and immunoglobulin class; whereas in Group II, which was composed of asymptomatic patients, two sera and three urines were identified to have monoclonal changes by immunoelectrophoresis but polyclonal changes by immunofixation electrophoresis. It is recommended that immunoelectrophoresis still be used for routine clinical service, but supplemented by immunofixation electrophoresis in equivocal cases, namely: (1) light-chain changes masked by an umbrella effect of immunoglobulin G (IgG); (2) abnormal bands located in atypical areas or overlapped with a normal serum protein; (3) a normal-looking "free" light chain present in the urine, mimicking Bence Jones protein; (4) controversial cases of biclonal gammopathy; (5) mini-monoclonal or oligoclonal protein bands; (6) immune complexes.
对60份样本（51份血清和9份尿液）进行了免疫固定电泳和免疫电泳比较，这些样本经电泳检测呈现明显均一的条带。为确定与临床结果的相关性，将患者分为三组：（1）有症状且免疫电泳图谱为单克隆型；（2）无症状且免疫电泳图谱为单克隆型；（3）无症状且免疫电泳图谱为多克隆型。在第I组和第III组的所有病例中，免疫电泳和免疫固定电泳在克隆性（即单克隆或多克隆）和免疫球蛋白类别方面的结果相互一致；而在由无症状患者组成的第II组中，免疫电泳鉴定出两份血清和三份尿液有单克隆变化，但免疫固定电泳显示为多克隆变化。建议免疫电泳仍用于常规临床检查，但在以下疑难病例中辅以免疫固定电泳：（1）免疫球蛋白G（IgG）的伞状效应掩盖轻链变化；（2）异常条带位于非典型区域或与正常血清蛋白重叠；（3）尿液中出现看似正常的“游离”轻链，类似本周蛋白；（4）双克隆丙种球蛋白病的争议病例；（5）微小单克隆或寡克隆蛋白条带；（6）免疫复合物。
