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首页> 外文期刊>Journal of Clinical Medicine Research >Serum Free Light Chain Assay and κ/λ Ratio: Performance in Patients With Monoclonal Gammopathy-High False Negative Rate for κ/λ Ratio
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Serum Free Light Chain Assay and κ/λ Ratio: Performance in Patients With Monoclonal Gammopathy-High False Negative Rate for κ/λ Ratio

机译：血清自由轻链测​​定和κ/λ比例：单克隆γ肠道患者的性能 - κ/λ比的高假负率

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Background: Serum free light chain assay (SFLCA) and κ/λ ratio, and protein electrophoretic methods are used in the diagnosis and monitoring of monoclonal gammopathies.Methods: Results for serum free light chains, serum and urine protein electrophoreses and immunofixation electrophoreses in 468 patients with a diagnosis of monoclonal gammopathy were compared. The results of the two methods were graded as concordant, non-concordant or discordant with the established diagnoses to assess the relative performance of the methods. Results of κ/λ ratio in samples with monoclonal protein detectable by electrophoretic methods were also analyzed.Results: Protein electrophoreses results were concordant with the established diagnoses significantly more often than κ/λ ratio. The false negative rate for κ/λ ratio was higher than that for electrophoretic methods. κ/λ ratio was falsely negative in about 27% of the 1,860 samples with detectable monoclonal immunoglobulin. The false negative rate was higher in lesions with lambda chains (32%) than those with kappa chains (24%). The false negative rate for κ/λ ratio was over 55% in samples with monoclonal gammopathy of undetermined significance. Even at first encounter, the false negative rates for κ/λ ratios for monoclonal gammopathy of undetermined significance, smoldering myeloma and multiple myeloma were 66.98%, 23.08%, and 30.15%, respectively, with false negative rate for lambda chain lesions being higher.Conclusions: Electrophoretic studies of serum and urine are superior to SFLCA and κ/λ ratio. Abnormal κ/λ ratio,?per se, is not diagnostic of monoclonal gammopathy. A normal κ/λ ratio does not exclude monoclonal gammopathy. False negative rates for lesions with lambda chain are higher than those for lesions with kappa chains. Electrophoretic studies of urine are underutilized. Clinical usefulness and medical necessity of SFLCA and κ/λ ratio is of questionable value in routine clinical testing.J Clin Med Res. 2017;9(1):46-57doi: https://doi.org/10.14740/jocmr2802w
机译：背景：血清自由轻链法测定（SFLCA）和κ/ /λ比，和蛋白质电泳方法用于单克隆γ病的诊断和监测。方法：血清自由光链，血清和尿蛋白电泳和免疫混膜电泳的结果468比较了诊断单克隆血杂散的患者。这两种方法的结果与已建立的诊断评估为协调，非协调剂或不和谐，以评估方法的相对性能。还分析了通过电泳方法检测到的单克隆蛋白质中的κ/λ比的结果。结果：蛋白质电泳结果与已建立的诊断显着更常见于κ/λ的比例。 κ/λ比的假负速率高于电泳方法的假负率。 κ/λ比例在1,860个样品中的约27％具有可检测的单克隆免疫球蛋白的约27％。假阴性速率在λ链（32％）的病变中较高，而不是kappa链（24％）。 κ/λ比的假阴性率在样品中超过55％，具有单克隆血管病的显着意义。即使首先遇到，κ/λ比对于单克隆血管病的比率未确定，骨髓瘤和多发性骨髓瘤的畸形负率分别为66.98％，23.08％和30.15％，对于λ链病变的假负速率分别更高。结论：血清和尿液的电泳研究优于SFLCA和κ/λ比。异常κ/ /λ比，α本身，不是单克隆γ肠道的诊断。常规κ/λ比不能排除单克隆血偶疗法。具有λ链的病变的假负率高于kappa链的病变。尿液的电泳研究未充分利用。 SFLCA和κ/λ比的临床有用性和医疗必要性是常规临床测试中的值得怀疑的值.J Clin Med Res。 2017; 9（1）：46-57DOI：https：//doi.org/10.14740/jocmr2802w

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