Senne Liquor Diagnóstico, São Paulo SP, Brazil.
Arq Neuropsiquiatr. 2024 Mar;82(3):1-5. doi: 10.1055/s-0044-1779690. Epub 2024 Mar 14.
Oligoclonal bands (OCBs) and Kappa free light chains (FLCs) in the cerebrospinal fluid (CSF) are sensitive markers of intrathecal immunoglobulin (Ig)G synthesis in patients with multiple sclerosis.
To evaluate the concordance rate between OCBCs and the Kappa index (KI) in patients with suspected multiple sclerosis (MS).
Patients with suspected MS were referred to a specialized CSF laboratory as part of their diagnostic investigation. Paired CSF and serum samples were collected and submitted to detection of OCBs and determination of the KI. Positive and negative results were determined with both methods, and the percentage of agreement between them was established.
In total, 171 serum and CSF samples from 171 patients were included in the analysis. The mean age of the patients was of 40 ± 14.2 years; 18.9% of them were male, and 81.1% were female. The OCBs and KI presented concordant results in 161 (94.2%) samples: in 74 (43.3%), both were positive, and in 87 (50.9%), both were negative. In 10 cases, the results were discrepant: KI positive/OCB negative in 8 and OCB positive/KI negative in 2 cases.
The KI and OCBs presented high concordance level. Currently, the detection of OCBs in the CSF is the standard method for MS diagnosis, but it is time-consuming, and its visual interpretation can be difficult. The results suggest that the KI is a good alternative for the detection of intrathecal immunoproduction in cases of suspected MS.
寡克隆带（OCB）和脑脊液中κ 游离轻链（FLC）是多发性硬化症患者鞘内免疫球蛋白（IgG）合成的敏感标志物。
评估疑似多发性硬化症（MS）患者的 OCB 与κ 指数（KI）之间的一致性。
疑似 MS 的患者被转介至专门的 CSF 实验室进行诊断性检查。采集配对的 CSF 和血清样本，并进行 OCB 检测和 KI 测定。用两种方法确定阳性和阴性结果，并确定它们之间的一致性百分比。
共纳入 171 例患者的 171 份血清和 CSF 样本。患者的平均年龄为 40±14.2 岁；男性占 18.9%，女性占 81.1%。OCB 和 KI 在 161 份（94.2%）样本中结果一致：74 份（43.3%）均为阳性，87 份（50.9%）均为阴性。在 10 例中，结果不一致：8 例 KI 阳性/OCB 阴性，2 例 OCB 阳性/KI 阴性。
KI 和 OCB 具有较高的一致性。目前，脑脊液中 OCB 的检测是 MS 诊断的标准方法，但该方法耗时，其视觉解释可能较为困难。结果表明，在疑似 MS 病例中，KI 是检测鞘内免疫产生的良好替代方法。
