Menéndez-Valladares P, García-Sánchez M I, Cuadri Benítez P, Lucas M, Adorna Martínez M, Carranco Galán V, García De Veas Silva J L, Bermudo Guitarte C, Izquierdo Ayuso G
Unidad de Gestión Clínica Bioquímica Clínica, Hospital Universitario Virgen Macarena, Spain.
Biobanco Hospitalario Virgen Macarena, Biobanco del Sistema Sanitario Público de Andalucía, Spain.
Mult Scler J Exp Transl Clin. 2015 Dec 16;1:2055217315620935. doi: 10.1177/2055217315620935. eCollection 2015 Jan-Dec.
Multiple sclerosis (MS) initiates with a first attack or clinically isolated syndrome (CIS). The importance of an early treatment in MS leads to the search, as soon as possible, for novel biomarkers which can predict conversion from CIS to MS.
The purpose of this study was to assess the predictive value of the kappa index ([Formula: see text] index), using kappa free light light chains ([Formula: see text]FLCs) in cerebrospinal fluid (CSF), for the conversion of CIS patients to MS, and compare its accuracy with other parameters used in clinical practice.
FLC levels were analysed in CSF from 176 patients: 70 as control group, 77 CIS, and 29 relapsing-remitting MS. FLC levels were quantified by nephelometry.
[Formula: see text] Index sensitivity and specificity (93.1%; 95.7%) was higher than those from the immunoglobulin G (IgG) index (75.9%; 94.3%), and lower than those from oligoclonal IgG bands (OCGBs) (96.5%; 98.6%). The optimal cut-off for [Formula: see text] index was 10.62. Most of the CIS patients with [Formula: see text] index >10.62 presented OCGBs, IgG index >0.56 and fulfilled magnetic resonance imaging (MRI) criteria.
CIS patients above [Formula: see text] index cut-off of 10.62 present 7.34-fold risk of conversion to MS than CIS below this value. The [Formula: see text] index correlated with positive OCGBs, IgG index above 0.56 and MRI criteria.
多发性硬化症（MS）始于首次发作或临床孤立综合征（CIS）。MS早期治疗的重要性促使人们尽快寻找能够预测CIS向MS转化的新型生物标志物。
本研究旨在评估脑脊液（CSF）中κ游离轻链（κFLC）的κ指数（[公式：见正文]指数）对CIS患者转化为MS的预测价值，并将其准确性与临床实践中使用的其他参数进行比较。
分析了176例患者脑脊液中的FLC水平：70例作为对照组，77例CIS患者，29例复发缓解型MS患者。通过散射比浊法对FLC水平进行定量。
[公式：见正文]指数的敏感性和特异性（93.1%；95.7%）高于免疫球蛋白G（IgG）指数（75.9%；94.3%），低于寡克隆IgG带（OCGBs）（96.5%；98.6%）。[公式：见正文]指数的最佳截断值为10.62。大多数κ指数>10.62的CIS患者出现OCGBs、IgG指数>0.56并符合磁共振成像（MRI）标准。
κ指数截断值高于10.62的CIS患者转化为MS的风险是该值以下CIS患者的7.34倍。κ指数与阳性OCGBs、IgG指数高于0.56以及MRI标准相关。
