血清游离轻链免疫测定在单克隆丙种球蛋白病诊断及随访中的应用价值
[Usefulness of a free light chain immunoassay in serum for the diagnosis and the follow-up of monoclonal gammopathy].
作者信息
Guenet L, Decaux O, Lechartier H, Ropert M, Grosbois B
机构信息
Service de biochimie, département de biochimie et de génétique moléculaire, CHU Pontchaillou, 2 rue Henri-Le-Guilloux, 35033 Rennes cedex, France.
出版信息
Rev Med Interne. 2007 Oct;28(10):689-97. doi: 10.1016/j.revmed.2007.04.010. Epub 2007 May 25.
PURPOSE
Monoclonal immunoglobulin free light chains (FLC) are present in the serum and urine of many patients with monoclonal gammopathies. In this review, we discuss the usefulness of serum FLC determination for diagnostic, prognostic and monitoring of multiple myeloma (MM), AL amyloidosis and monoclonal gammopathies of undetermined significance (MGUS).
CURRENT KNOWLEDGE AND KEY POINTS
Serum FLC assay is a useful laboratory test for management of light chain MM, non-secretory MM and AL amyloidosis. Currently, serum FLC testing cannot be recommended for monitoring intact immunoglobulin multiple myeloma. Even though serum FLC determination give a better risk stratification for MGUS, systematic serum FLC assay should not be used in routine because of high MGUS occurrence in the general population.
FUTURE PROSPECTS AND PROJECTS
Further prospective studies with large cohorts of patients should provide additional evidence for the role of serum FLC measurement in patients with intact immunoglobulin multiple myeloma.
目的
单克隆免疫球蛋白游离轻链（FLC）存在于许多单克隆丙种球蛋白病患者的血清和尿液中。在本综述中，我们讨论血清FLC测定在多发性骨髓瘤（MM）、AL淀粉样变性和意义未明的单克隆丙种球蛋白病（MGUS）的诊断、预后评估及监测中的作用。
当前知识与要点
血清FLC检测对于轻链型MM、非分泌型MM和AL淀粉样变性的管理是一项有用的实验室检查。目前，血清FLC检测不推荐用于监测完整免疫球蛋白型多发性骨髓瘤。尽管血清FLC测定可为MGUS提供更好的风险分层，但由于一般人群中MGUS发生率高，常规情况下不应进行系统性血清FLC检测。
未来展望与计划
对大量患者队列进行进一步的前瞻性研究，应为血清FLC检测在完整免疫球蛋白型多发性骨髓瘤患者中的作用提供更多证据。
Zotero 插件