文章：

质谱技术用于多发性骨髓瘤及相关疾病中单克隆蛋白的评估：国际骨髓瘤工作组质谱委员会报告

Mass spectrometry for the evaluation of monoclonal proteins in multiple myeloma and related disorders: an International Myeloma Working Group Mass Spectrometry Committee Report

原文发布日期：2021-02-01

DOI: 10.1038/s41408-021-00408-4

类型: Article

开放获取: 是

英文摘要：

Plasma cell disorders (PCDs) are identified in the clinical lab by detecting the monoclonal immunoglobulin (M-protein) which they produce. Traditionally, serum protein electrophoresis methods have been utilized to detect and isotype M-proteins. Increasing demands to detect low-level disease and new therapeutic monoclonal immunoglobulin treatments have stretched the electrophoretic methods to their analytical limits. Newer techniques based on mass spectrometry (MS) are emerging which have improved clinical and analytical performance. MS is gaining traction into clinical laboratories, and has replaced immunofixation electrophoresis (IFE) in routine practice at one institution. The International Myeloma Working Group (IMWG) Mass Spectrometry Committee reviewed the literature in order to summarize current data and to make recommendations regarding the role of mass spectrometric methods in diagnosing and monitoring patients with myeloma and related disorders. Current literature demonstrates that immune-enrichment of immunoglobulins coupled to intact light chain MALDI-TOF MS has clinical characteristics equivalent in performance to IFE with added benefits of detecting additional risk factors for PCDs, differentiating M-protein from therapeutic antibodies, and is a suitable replacement for IFE for diagnosing and monitoring multiple myeloma and related PCDs. In this paper we discuss the IMWG recommendations for the use of MS in PCDs.
 

摘要翻译： 

浆细胞疾病（PCDs）的检测在临床实验室中主要通过识别其产生的单克隆免疫球蛋白（M蛋白）来实现。传统上，血清蛋白电泳技术被用于检测及鉴定M蛋白的同种型。随着对低水平疾病检测需求的增加以及新型治疗性单克隆免疫球蛋白疗法的出现，电泳方法已接近其分析能力的极限。基于质谱分析法的新兴技术正逐渐崭露头角，其在临床和分析性能方面均有所提升。质谱技术正逐步进入临床实验室，并在某医疗机构中替代了免疫固定电泳作为常规检测手段。国际骨髓瘤工作组质谱委员会通过文献综述，总结了当前数据，并就质谱方法在多发性骨髓瘤及相关疾病的诊断与监测中的作用提出建议。现有文献表明，免疫富集联合完整轻链基质辅助激光解吸电离飞行时间质谱的检测性能与免疫固定电泳相当，同时具有附加优势：可识别更多浆细胞疾病风险因素、能区分M蛋白与治疗性抗体，适用于多发性骨髓瘤及相关浆细胞疾病的诊断与监测，可作为免疫固定电泳的替代方法。本文探讨了国际骨髓瘤工作组关于质谱技术在浆细胞疾病中应用的相关建议。

原文链接：

Mass spectrometry for the evaluation of monoclonal proteins in multiple myeloma and related disorders: an International Myeloma Working Group Mass Spectrometry Committee Report