采用血清游离轻链分析和尿蛋白电泳检测单克隆丙种球蛋白病。
Use of serum free light chain analysis and urine protein electrophoresis for detection of monoclonal gammopathies.
机构信息
Department of Immunology, Hull Royal Infirmary, Hull, UK.
出版信息
Clin Chem Lab Med. 2011 Jan;49(1):83-8. doi: 10.1515/CCLM.2011.010. Epub 2010 Oct 20.
BACKGROUND
Serum free light chain (FLC) analysis is used in the prognostic assessment and monitoring of patients with monoclonal gammopathies (MG). Its use in detection of MG is less widespread despite good sensitivity for diseases poorly detected by serum protein electrophoresis (SPE), e.g., FLC disease and AL amyloidosis. FLC analysis may facilitate earlier diagnosis in these diseases. However, if replacing urine protein electrophoresis (UPE) in an initial screening algorithm, this must be balanced against any loss of detection of Bence Jones proteinuria (BJP).
METHODS
We assessed the effect of replacing UPE with FLC. Sensitivity of FLC for BJP was assessed in 126 clinical cases where UPE and FLC analyses were performed. Impact on disease detection was assessed from 753 patient sera tested by SPE and FLC and 128 patients matched associated urine samples.
RESULTS
Sensitivity of FLC for BJP was 98%. Use of FLC in routine testing increased the number of MG detected by 7%.
CONCLUSIONS
Using FLC alongside or in place of UPE can give clinical benefit through earlier diagnosis and hence treatment earlier in the patients' disease.
背景
血清游离轻链（FLC）分析用于单克隆丙种球蛋白病（MG）患者的预后评估和监测。尽管 FLC 对血清蛋白电泳（SPE）检测效果不佳的疾病（如 FLC 疾病和 AL 淀粉样变性）具有很好的敏感性，但它在 MG 的检测中的应用并不广泛。FLC 分析可促进这些疾病的早期诊断。然而，如果在初始筛选算法中用 FLC 替代尿蛋白电泳（UPE），则必须权衡其对 BJP 检测的任何损失。
方法
我们评估了用 FLC 替代 UPE 的效果。在进行 UPE 和 FLC 分析的 126 例临床病例中，评估了 FLC 对 BJP 的敏感性。通过 SPE 和 FLC 检测的 753 例患者血清和 128 例配对尿液样本评估了对疾病检测的影响。
结果
FLC 对 BJP 的敏感性为 98%。在常规检测中使用 FLC 可使 MG 的检出率增加 7%。
结论
与 UPE 联合使用或替代 UPE 可通过更早地诊断和更早地对患者进行治疗，从而为临床带来益处。
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