多发性硬化症中游离κ轻链作为鞘内体液反应标志物的性别分层研究

Kappa Free Light Chains in Multiple Sclerosis as a Marker of Intrathecal Humoral Response: A Sex-Disaggregated Study.

作者信息

Candeloro Raffaella, Galloppa Maila, Lombardo Laura, Laudisi Michele, Ghisellini Sara, Negri Giovanna, Ferri Caterina, Marcialis Carla, Bellini Tiziana, Pugliatti Maura, Castellazzi Massimiliano

机构信息

Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy.

Department of Neuroscience, "S. Anna" University Hospital, 44124 Ferrara, Italy.

出版信息

Diagnostics (Basel). 2024 Dec 12;14(24):2798. doi: 10.3390/diagnostics14242798.

DOI:10.3390/diagnostics14242798

PMID:39767159

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11674690/

Abstract

BACKGROUND

Kappa free light chains (KFLCs) are emerging as promising biomarkers for intrathecal B cell activity for diagnosing multiple sclerosis (MS) through cerebrospinal fluid (CSF) analysis. In this study, we evaluated the ability of KFLC formulas to identify the presence of MS and their agreement with the 'gold standard' of CSF IgG oligoclonal bands (OCBs).

METHODS

A total of 233 patients were included in this study: 149, comprising 43 males and 106 females, had MS, and the remainder, 40 males and 44 females, had other neurological diseases (ONDs). We evaluated the potential of KFLCs in terms of sensitivity, specificity, and accordance. All analyses were conducted using a sex-disaggregated approach.

RESULTS

KFLCs showed a high sensitivity for both sexes with respect to the diagnosis of MS, with values between 74.42% and 93.03%. The specificity of the various formulas was much lower for females when compared to males, with values between 45.45% and 59.09%, with a significant difference between the two sexes for the K Index > 5.9 ( = 0.0451). Cohen's kappa showed substantial agreement for men and moderate agreement for women between the KFLC indices and OCB.

CONCLUSIONS

This study highlights the potential of KFLCs as a biomarker for MS but emphasises the need for sex-specific thresholds to improve diagnostic accuracy.

摘要

背景

κ游离轻链（KFLCs）正逐渐成为用于鞘内B细胞活性的有前景的生物标志物，可通过脑脊液（CSF）分析来诊断多发性硬化症（MS）。在本研究中，我们评估了KFLC公式识别MS存在的能力及其与CSF IgG寡克隆带（OCBs）“金标准”的一致性。

方法

本研究共纳入233例患者：149例患有MS，其中男性43例，女性106例；其余患者，男性40例，女性44例，患有其他神经系统疾病（ONDs）。我们从敏感性、特异性和一致性方面评估了KFLCs的潜力。所有分析均采用按性别分类的方法进行。

结果

KFLCs在诊断MS方面对两性均显示出高敏感性，值在74.42%至93.03%之间。与男性相比，各种公式对女性的特异性要低得多，值在45.45%至59.09%之间，对于K指数>5.9，两性之间存在显著差异（P = 0.0451）。Cohen's kappa显示，KFLC指数与OCB之间，男性有高度一致性，女性有中度一致性。