Duc J, Morel B, Peitrequin R, Frei P C
Division of Immunology and Allergy, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
J Clin Lab Immunol. 1988 Jul;26(3):141-6.
We study whether immunoelectrophoresis (IE) could be replaced by immunofixation (IF) for the routine diagnosis of monoclonal gammopathies and/or by a quantitative measurement of kappa-resp. lambda-Ig levels in serum. The values of these measurements, together with the level of each Ig class, were used to calculate two ratios. IF, IE and calculation of both ratios were simultaneously applied to 153 serum samples. A monoclonal gammopathy (MGP) was found with all three methods in 51 cases and by none of them in another 51 cases. The first two techniques were positive and the third one negative in 16 cases. In 15 cases, IF showed the presence of a MGP, which was not or incompletely identified with IE, these results being associated with normal (7x) or abnormal ratios (8x). Nineteen cases with normal IF and IE had one or two abnormal ratios. After comparison with clinical data and outcome, we conclude that IF revealed 15 cases of MGP, which were not or only partially shown by IE. IE did not show any case of MGP not detected by IF. One of the ratios appeared as an interesting adjunct to the diagnostic procedure, but insufficient to be used as a single test. The other appeared to be of no diagnostic help. We conclude that immunofixation is the test of choice in the routine diagnosis of monoclonal gammopathies.
我们研究免疫电泳（IE）是否可以被免疫固定电泳（IF）替代用于单克隆丙种球蛋白病的常规诊断，以及/或者是否可以通过定量测定血清中κ-和λ-免疫球蛋白水平来替代。这些测量值连同每种免疫球蛋白类别的水平一起用于计算两个比值。IF、IE以及两个比值的计算同时应用于153份血清样本。51例患者通过这三种方法均检测到单克隆丙种球蛋白病（MGP），另有51例患者三种方法均未检测到。16例患者前两种技术检测为阳性而第三种为阴性。15例患者中，IF显示存在MGP，但IE未检测到或未完全识别，这些结果与正常（7例）或异常比值（8例）相关。19例IF和IE结果正常的患者有一或两个异常比值。与临床数据和结果进行比较后，我们得出结论，IF检测出15例IE未检测到或仅部分显示的MGP。IE未显示出任何IF未检测到的MGP病例。其中一个比值似乎是诊断过程中的一个有趣辅助指标，但不足以作为单一检测方法使用。另一个比值似乎无助于诊断。我们得出结论，免疫固定电泳是单克隆丙种球蛋白病常规诊断的首选检测方法。
