Sezione di Neurologia, Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy.
Laboratorio di Patologia Clinica, Azienda Ospedaliera S. Maria della Misericordia, Perugia, Italy.
J Neuroimmunol. 2020 Feb 15;339:577108. doi: 10.1016/j.jneuroim.2019.577108. Epub 2019 Nov 7.
Cerebrospinal fluid (CSF) free light chains (FLC) may be an alternative biomarker to oligoclonal bands (OCB) in multiple sclerosis (MS). Herein, we compared the diagnostic accuracy of CSF OCB and FLC and we tested the prognostic value of FLC in a cohort of 64 MS patients and 106 controls. A κ-index >7.83 was more sensitive but less specific than OCB in discriminating MS patients from controls. Additionally, a κ-index >10.61 performed better than OCB in the discrimination between MS and controls with inflammatory neurological diseases (p < .001). In clinically isolated syndrome (CIS) patients, a κ-index >10.61 significantly predicted time to conversion to MS (p = .020). κ-index might be a valid alternative to OCB as a diagnostic biomarker for MS and might also be a prognostic marker in CIS.
脑脊液（CSF）游离轻链（FLC）可能是多发性硬化症（MS）中寡克隆带（OCB）的替代生物标志物。在此，我们比较了 CSF OCB 和 FLC 的诊断准确性，并在 64 例 MS 患者和 106 例对照者中测试了 FLC 的预后价值。κ 指数＞7.83 比 OCB 更敏感但特异性更低，可用于区分 MS 患者与对照者。此外，κ 指数＞10.61 比 OCB 更能区分 MS 和伴有炎症性神经系统疾病的对照者（p＜.001）。在临床孤立综合征（CIS）患者中，κ 指数＞10.61 显著预测向 MS 转化的时间（p=0.020）。κ 指数可能是 MS 的 OCB 替代诊断生物标志物，也可能是 CIS 的预后标志物。
