Screening panels for detection of monoclonal gammopathies.
Screening panels for detection of monoclonal gammopathies.
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DOI：
10.1373/clinchem.2009.126664
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发表时间：
2009-08
影响因子：
9.3
通讯作者：
Dispenzieri A
中科院分区：
文献类型：
--
作者：
Katzmann JA;Kyle RA;Benson J;Larson DR;Snyder MR;Lust JA;Rajkumar SV;Dispenzieri A
用于鉴定单克隆丙种球蛋白病的血清学试验包括血清和尿蛋白电泳（PEL）、血清和尿免疫固定电泳（IFE）和定量血清游离轻链（FLC）。虽然有几个报告的相对诊断贡献，这些检测，没有一个单独的测试和各种浆细胞增殖性疾病（PCPD）的组合。纳入了患有PCPD且在诊断后30天内进行了所有5项检测的患者（n = 1877）。诊断为多发性骨髓瘤（MM）（n = 467）、郁积型多发性骨髓瘤（SMM）（n =191）、意义不明的单克隆丙种球蛋白病（MGUS）（n = 524）、浆细胞瘤（n = 29）、髓外浆细胞瘤（n = 10）、Waldenström巨球蛋白血症（WM）（n = 26）、原发性淀粉样变性（AL）（n = 581）、轻链沉积病（LCDD）（n =18）和POEMS综合征（n = 31）。在1877例患者中，26例在所有检测中均为阴性。从样本组中省略尿液额外丢失了23例患者（15例MGUS，6例AL，1例浆细胞瘤，1例LCDD），而省略FLC丢失了30例患者（6例MM，23例AL和1例LCDD）。遗漏血清IFE以及尿液，额外丢失了58例患者（44例MGUS，7例POEMS，5例AL，1例SMM和1例浆细胞瘤）。使用血清PEL + FLC而非PEL、IFE和FLC的简化筛查组的主要影响是MGUS敏感性降低8%，POEMS（7例患者）降低23%，浆细胞瘤（1例患者）降低4%，AL降低1%，SMM降低0.5%。检测MM、巨球蛋白血症和LCDD的灵敏度没有降低。
The repertoire of serologic tests for identifying a monoclonal gammopathy includes serum and urine protein electrophoresis (PEL), serum and urine immunofixation electrophoresis (IFE), and quantitative serum free light chain (FLC). Although there are several reports on the relative diagnostic contribution of these assays, none has looked at the tests singly and in combination for the various plasma cell proliferative disorders (PCPDs). Patients with a PCPD and all 5 assays performed within 30 days of diagnosis were included (n = 1877). The diagnoses were multiple myeloma (MM) (n = 467), smoldering multiple myeloma (SMM) (n =191), monoclonal gammopathy of undetermined significance (MGUS) (n = 524), plasmacytoma (n = 29), extramedullary plasmacytoma (n = 10), Waldenström macroglobulinemia (WM) (n = 26), primary amyloidosis (AL) (n = 581), light chain deposition disease (LCDD) (n =18), and POEMS syndrome (n = 31). Of the 1877 patients, 26 were negative in all assays. Omitting urine from the panel lost an additional 23 patients (15 MGUS, 6 AL, 1 plasmacytoma, 1 LCDD), whereas the omission of FLC lost 30 patients (6 MM, 23 AL, and 1 LCDD). The omission of serum IFE as well as urine lost an additional 58 patients (44 MGUS, 7 POEMS, 5 AL, 1 SMM, and 1 plasmacytoma). The major impact of using a simplified screening panel of serum PEL plus FLC rather than PEL, IFE, and FLC is an 8% reduction in sensitivity for MGUS, 23% for POEMS (7 patients), 4% for plasmacytoma (1 patient), 1% for AL, and 0.5% for SMM. There is no diminution in sensitivity for detecting MM, macroglobulinemia, and LCDD.
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影响因子：
9.3
作者：
Katzmann, JA;Abraham, RS;Kyle, RA
通讯作者：
Kyle, RA
影响因子：
10.1
作者：
Bochtler, Tilmann;Hegenbart, Ute;Schonland, Stefan O.
通讯作者：
Schonland, Stefan O.
影响因子：
8.9
作者：
Katzmann, Jerry A.;Dispenzieri, Angela;Rajkumar, S. Vincent
通讯作者：
Rajkumar, S. Vincent
影响因子：
20.3
作者：
Drayson, M;Tang, LX;Bradwell, AR
通讯作者：
Bradwell, AR
影响因子：
158.5
作者：
Kyle, RA;Therneau, TM;Melton, L
通讯作者：
Melton, L