文章：

意义未明单克隆丙种球蛋白病的检出率与患病率：一项基于质谱单克隆免疫球蛋白快速准确质量测量的研究

Detection and prevalence of monoclonal gammopathy of undetermined significance: a study utilizing mass spectrometry-based monoclonal immunoglobulin rapid accurate mass measurement

原文发布日期：2019-12-13

DOI: 10.1038/s41408-019-0263-z

类型: Article

开放获取: 是

英文摘要：

High-sensitivity mass spectrometry assays are available to detect monoclonal immunoglobulins. To better assess the prevalence of monoclonal gammopathy of undetermined significance (MGUS), we identified 300 patients diagnosed with MGUS or related gammopathy who had a prior negative work-up for monoclonal proteins as part of the Olmsted County MGUS screening study. Two mass spectrometry-based detection methods (matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) and monoclonal immunoglobulin rapid accurate mass measurements (miRAMM) along with traditional immunofixation were performed on the Olmsted baseline and MGUS diagnostics serum samples. Among the 226 patients considered negative for MGUS based on protein electrophoresis and serum-free light-chain assay, a monoclonal protein could be detected at baseline in 24 patients (10.6%) by immunofixation, 113 patients (50%) by MADLI-TOF mass spectrometry, and 149 patients (65.9%) by miRAMM mass spectrometry. In addition, using miRAMM, some patients demonstrated an oligoclonal to monoclonal transition giving insight into the origin of MGUS. Using the sensitive miRAMM, MGUS is present in 887 of 17,367 persons from the Olmsted County cohort, translating into a prevalence of 5.1% among persons 50 years of age and older. This represents the most accurate prevalence estimate of MGUS thus far.
 

摘要翻译： 

高灵敏度质谱检测法可用于检测单克隆免疫球蛋白。为了更好地评估意义未明的单克隆丙种球蛋白病（MGUS）的患病率，我们选取了奥姆斯特德县MGUS筛查研究中300名确诊MGUS或相关丙种球蛋白病、但既往单克隆蛋白检测呈阴性的患者。研究人员对奥姆斯特德基线血清样本和MGUS诊断血清样本分别采用两种质谱检测方法（基质辅助激光解吸/电离飞行时间质谱[MALDI-TOF]和单克隆免疫球蛋白快速精确质量测定[miRAMM]）及传统免疫固定电泳进行检测。在基于蛋白电泳和血清游离轻链检测判定为MGUS阴性的226名患者中，基线期通过免疫固定电泳检测到24例（10.6%）存在单克隆蛋白，通过MALDI-TOF质谱检测到113例（50%），通过miRAMM质谱检测到149例（65.9%）。此外，利用miRAMM技术发现部分患者存在寡克隆向单克隆的转化，这为MGUS的起源提供了线索。通过高灵敏度的miRAMM技术检测，奥姆斯特德县队列17,367人中有887人存在MGUS，换算为50岁及以上人群的患病率达5.1%。这代表了迄今最精确的MGUS患病率评估数据。

原文链接：

Detection and prevalence of monoclonal gammopathy of undetermined significance: a study utilizing mass spectrometry-based monoclonal immunoglobulin rapid accurate mass measurement