Disease spectrum of abnormal serum free light chain ratio and its diagnostic significance

Bin Xu; Yi Tang; Jianfeng Zhou; Peiling Zhang; Huijun Li

doi:10.18632/oncotarget.19391

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Research Papers:

Disease spectrum of abnormal serum free light chain ratio and its diagnostic significance

Bin Xu, Yi Tang _, Jianfeng Zhou, Peiling Zhang and Huijun Li

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Oncotarget. 2017; 8:82268-82279. https://doi.org/10.18632/oncotarget.19391

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Abstract

Bin Xu1, Yi Tang1, Jianfeng Zhou1, Peiling Zhang1 and Huijun Li2

1Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

2Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

Correspondence to:

Yi Tang, email: [email protected]

Keywords: abnormal serum free light chain ratio, cut-off value, malignant plasma diseases, MGUS, reactive plasma diseases

Received: April 04, 2017 Accepted: June 11, 2017 Published: July 19, 2017

ABSTRACT

Objective: To analyze the spectrum of abnormal serum free light chain ratio (sFLC κ/λ ratio), and to redefine the range of sFLC κ/λ ratio, so as to achieve hierarchical diagnosis of diseases with abnormal sFLC κ/λ ratio, resulting in the increased sensitivity and specificity in the diagnosis of monoclonal plasma diseases.

Methods: Enrolled 1,340 patients with abnormal sFLC κ/λ ratio (<0.26 or >1.65) were grouped: (1) group A: malignant plasma diseases; (2) group B: monoclonal gammopathies of undetermined significance (MGUS); (3) group C: reactive plasma diseases. These patients were further divided by renal function eGFR <60 or >60 ml/min/1.73m² to eliminate renal diseases influencing the results. Statistical analyses was performed by using SPSS 22 software.

Results: When sFLC κ/λ ratio >3.49 and eGFR >60ml/min/1.73m², the sensitivity and specificity of the diagnosis of malignant plasma diseases were 86.1% and 94.0%, respectively. When sFLC κ/λ ratio >2.89 and eGFR <60ml/min/1.73m², the sensitivity and specificity of the diagnosis of malignant plasma diseases were 92.0% and 97.0%, respectively.

Conclusion: The sensitivity and specificity of the diagnosis of monoclonal plasma diseases can be significantly improved by redefining the cut-off value of sFLC κ/λ ratio and the renal function index of eGFR.

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Research Papers:

Disease spectrum of abnormal serum free light chain ratio and its diagnostic significance

Abstract