Lopez J, Dauwalder O, Joly P, Dimet I, Bienvenu J, Bernon H
Laboratoire d'immunologie, Centre hospitalier Lyon Sud, Pierre-Bénite.
Ann Biol Clin (Paris). 2006 May-Jun;64(3):287-97.
This work aims to define the interest and the limits of free light chain (FLC) determination in serum and urine for the investigation of monoclonal gammopathies. Based on the study of nine typical cases extracted from laboratory practice, the authors demonstrate the interest of this determination for the diagnosis and the monitoring of FLC and non secretory myelomas. This test is also useful for the evaluation of response to chemotherapy and the early detection of relapses in intact immunoglobulin multiple myelomas. These results are discussed in the light of the literature with a special emphasis on AL amyloidosis and monoclonal gammapathy of undetermined significance (MGUS). Finally the authors underline some limitations leading to an overestimation of the results in certain patients together with the difficulty to interpret data when a renal damage is associated.
这项工作旨在确定血清和尿液中游离轻链（FLC）测定对于单克隆丙种球蛋白病研究的意义及局限性。基于从实验室实践中提取的9个典型病例的研究，作者证明了该测定对于FLC和非分泌性骨髓瘤的诊断及监测的意义。该检测对于评估化疗反应以及检测完整免疫球蛋白多发性骨髓瘤的早期复发也很有用。结合文献对这些结果进行了讨论，特别强调了AL淀粉样变性和意义未明的单克隆丙种球蛋白病（MGUS）。最后，作者强调了一些局限性，这些局限性会导致某些患者的结果被高估，以及在伴有肾损害时难以解释数据。
