Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
Expert Rev Mol Diagn. 2014 Jan;14(1):55-66. doi: 10.1586/14737159.2014.864557. Epub 2013 Nov 28.
The serum free light chain (FLC) assay is an important tool in the management of patients with monoclonal gammopathies. MEDLINE, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews from January 2000 through July 2013, were used as data sources. The available evidence is rather weak. For screening of multiple myeloma and related conditions, the association of the FLC assay with the traditional serum tests avoids urine study. Screening for immunoglobulin light-chain (AL) amyloidosis or other rare syndromes requires the urine examination. FLC measurement is used in the assessment of the risk of progression of precursor diseases to overt myeloma, and for risk stratification in solitary plasmacytoma, multiple myeloma and AL amyloidosis. In patients with oligosecretory myeloma and AL amyloidosis, the quantification of FLC is essential for monitoring and categorization of response to therapy. Further studies with improved design are warranted to strengthen the available evidence.
血清游离轻链（FLC）检测是单克隆丙种球蛋白病患者管理的重要工具。我们检索了 MEDLINE、Cochrane 对照试验中心注册库和 Cochrane 系统评价数据库，检索时间从 2000 年 1 月至 2013 年 7 月。现有证据的强度相当弱。为了筛查多发性骨髓瘤及相关疾病，FLC 检测与传统血清学检测联合应用可避免尿液检查。为了筛查免疫球蛋白轻链（AL）淀粉样变性或其他罕见综合征，则需要进行尿液检查。FLC 检测可用于评估前体疾病进展为显性骨髓瘤的风险，也可用于孤立性浆细胞瘤、多发性骨髓瘤和 AL 淀粉样变性的危险分层。在寡分泌型骨髓瘤和 AL 淀粉样变性患者中，定量检测 FLC 对于监测和分类评估治疗反应至关重要。需要进一步设计良好的研究来加强现有证据。
