Clark R, Katzmann J A, Kyle R A, Fleisher M, Landers J P
Department of Laboratory Medicine and Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Electrophoresis. 1998 Oct;19(14):2479-84. doi: 10.1002/elps.1150191421.
The capabilities of capillary electrophoresis (CE) for serum protein electrophoresis and immunotyping have been demonstrated. CE-based systems specifically designed for serum protein electrophoresis and immunotyping via immunosubtraction (IS) are now available and are being evaluated for efficiency, specificity and sensitivity by several groups. The use of CE for serum protein electrophoresis and immunotyping (IS) in the clinical laboratory compares well with agarose gel electrophoresis (AGE) and immunofixation (IF) for the detection and characterization of monoclonal proteins. In addition to routine use, this technology is useful for a subset of serum samples that are difficult to interpret with conventional technology. In this study, sera abnormalities difficult to detect/interpret by AGE-IF are subdivided into four categories: (i) patients with polyclonal increases in immunoglobulin, (ii) point of application artifacts, (iii) abnormalities in the beta region, and (iv) patients with free light chains. CE is superior to AGE for evaluating samples characterized by the above abnormalities. Sera containing monoclonal proteins within a polyclonal increase are easier to detect by CE as well as being easier to type by IS than by IF. Point-of-application artifacts, periodically observed with AGE, do not exist on CE since the point of detection is remote from the point of application. Enhanced resolution in the beta region allows for increased detection of monoclonal proteins migrating in this region. Some free light chains are undetected by CE as a result of no apparent abnormalities on the CE serum protein profile and, thus, still require IF for detection. CE detects more serum electrophoretic abnormalities than AGE in this clinically important group of patients with Bence Jones proteinemia.
毛细管电泳（CE）用于血清蛋白电泳和免疫分型的能力已得到证实。专门为血清蛋白电泳和通过免疫减法（IS）进行免疫分型设计的基于CE的系统现已可用，并且几个研究小组正在对其效率、特异性和灵敏度进行评估。在临床实验室中，将CE用于血清蛋白电泳和免疫分型（IS）与琼脂糖凝胶电泳（AGE）和免疫固定（IF）在检测和鉴定单克隆蛋白方面效果相当。除常规应用外，该技术对于一部分难以用传统技术解释的血清样本也很有用。在本研究中，难以通过AGE-IF检测/解释的血清异常情况可分为四类：（i）免疫球蛋白多克隆增加的患者，（ii）加样点假象，（iii）β区异常，以及（iv）游离轻链患者。在评估具有上述异常特征的样本时，CE优于AGE。与IF相比，CE更容易检测出多克隆增加范围内含有单克隆蛋白的血清，并且通过IS进行分型也更容易。AGE中定期观察到的加样点假象在CE中不存在，因为检测点远离加样点。β区分辨率的提高使得在该区域迁移的单克隆蛋白更容易被检测到。由于CE血清蛋白图谱上没有明显异常，一些游离轻链无法被CE检测到，因此仍需要IF进行检测。在这一具有临床重要意义的本-周蛋白尿患者群体中，CE检测到的血清电泳异常情况比AGE更多。
