Milani Paolo, Palladini Giovanni, Merlini Giampaolo
a Amyloidosis Research and Treatment Center, Foundation IRCCS Policlinico San Matteo and Department of Molecular Medicine , University of Pavia , Pavia , Italy.
Scand J Clin Lab Invest Suppl. 2016;245:S113-8. doi: 10.1080/00365513.2016.1210337. Epub 2016 Jul 28.
The introduction of the serum-free light-chain (S-FLC) assay has been a breakthrough in the diagnosis and management of plasma cell dyscrasias, particularly monoclonal light-chain diseases. The first method, proposed in 2001, quantifies serum-free light-chains using polyclonal antibodies. More recently, assays based on monoclonal antibodies have entered into clinical practice. S-FLC measurement plays a central role in the screening for multiple myeloma and related conditions, in association with electrophoretic techniques. Analysis of S-FLC is essential in assessing the risk of progression of precursor diseases to overt plasma cell dyscrasias. It is also useful for risk stratification in solitary plasmacytoma and AL amyloidosis. The S-FLC measurement is part of the new diagnostic criteria for multiple myeloma, and provides a marker to follow changes in clonal substructure over time. Finally, the evaluation of S-FLC is fundamental for assessing the response to treatment in monoclonal light chain diseases.
血清游离轻链（S-FLC）检测方法的引入是浆细胞异常增殖性疾病，尤其是单克隆轻链疾病诊断和管理方面的一项突破。2001年提出的第一种方法使用多克隆抗体对血清游离轻链进行定量。最近，基于单克隆抗体的检测方法已进入临床实践。S-FLC检测在与电泳技术联合用于多发性骨髓瘤及相关病症的筛查中起着核心作用。S-FLC分析对于评估前驱疾病进展为明显浆细胞异常增殖性疾病的风险至关重要。它在孤立性浆细胞瘤和AL淀粉样变性的风险分层中也很有用。S-FLC检测是多发性骨髓瘤新诊断标准的一部分，并提供了一个追踪克隆亚结构随时间变化的标志物。最后，S-FLC评估对于评估单克隆轻链疾病的治疗反应至关重要。
