Brigden M L, Neal E D, McNeely M D, Hoag G N
Island Medical Laboratories, Victoria, British Columbia, Canada.
Am J Clin Pathol. 1990 May;93(5):689-93. doi: 10.1093/ajcp/93.5.689.
Twenty patients with malignant disease and Bence Jones (BJ) proteins were studied to determine the optimum urine collections for the detection and monitoring of light chain proteinuria. A 24-hour urine protein collection was followed by individual collections of each sequentially voided specimen over the same time interval. Samples were analyzed quantitatively for protein, and protein electrophoresis was performed on each specimen. Only one patient had BJ protein nondetectable by protein electrophoresis in the early morning specimen. Six patients had one or more random specimens (excluding the early morning specimens) absent for BJ protein on protein electrophoresis. Three patients had nondetectable protein on electrophoresis of the 24-hour specimen despite having some random specimens positive. All random specimens with protein values exceeding 0.20 g/L had BJ protein visibly detectable on electrophoresis. Thirteen specimens with protein less than 0.05 g/L still had BJ protein detected by electrophoresis. There was a linear relationship between the early morning protein concentration and the total 24-hour urinary protein production. The authors conclude that early morning specimens or 24-hour urine collections are preferable for the detection and monitoring of light chain proteinuria. These collection methods are not mutually exclusive because there are individual patients who will be negative in one collection but positive in the other.
对20例患有恶性疾病且伴有本-周蛋白（BJ）的患者进行了研究，以确定用于检测和监测轻链蛋白尿的最佳尿液收集方法。先进行24小时尿蛋白收集，然后在相同时间间隔内对每次依次排出的标本进行单独收集。对样本进行蛋白质定量分析，并对每个标本进行蛋白质电泳。只有1例患者在清晨标本中通过蛋白质电泳检测不到BJ蛋白。6例患者在蛋白质电泳中，有一个或多个随机标本（不包括清晨标本）未检测到BJ蛋白。3例患者尽管有一些随机标本呈阳性，但24小时标本电泳时蛋白质检测不到。所有蛋白质值超过0.20g/L的随机标本在电泳时都能明显检测到BJ蛋白。13份蛋白质含量低于0.05g/L的标本在电泳时仍检测到BJ蛋白。清晨蛋白质浓度与24小时尿蛋白总量之间存在线性关系。作者得出结论，清晨标本或24小时尿液收集对于检测和监测轻链蛋白尿更可取。这些收集方法并非相互排斥，因为有个别患者在一种收集方法中呈阴性，但在另一种收集方法中呈阳性。
