文章：

MASS-FIX在常规临床实践中检测单克隆蛋白和轻链N-糖基化：一项6315例患者的横断面研究

MASS-FIX for the detection of monoclonal proteins and light chain N-glycosylation in routine clinical practice: a cross-sectional study of 6315 patients

原文发布日期：2021-03-04

DOI: 10.1038/s41408-021-00444-0

类型: Article

开放获取: 是

英文摘要：

Immunoenrichment-based matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS), termed MASS-FIX, offers several advantages over immunofixation for the detection and isotyping of serum monoclonal protein, including superior sensitivity and specificity, the ability to differentiate therapeutic monoclonal antibodies, and the rapid identification of light chain (LC) N-glycosylation. We identified 6315 patients with MASS-FIX performed at our institution since 2018. Of these, 4118 patients (65%) with a wide array of plasma cell disorders (PCD), including rare monoclonal gammopathies of clinical significance, had a positive MASS-FIX. Two-hundred twenty-one (5%) of the MASS-FIX positive patients had evidence of LC N-glycosylation, which was more commonly identified in IgM heavy chain isotype, kappa LC isotype, and in diagnoses of immunoglobulin light chain (AL) amyloidosis and cold agglutinin disease (CAD) compared to other PCD. This cross-sectional study describes the largest cohort of patients to undergo MASS-FIX in routine clinical practice. Our findings demonstrate the widespread utility of this assay, and confirm that LC N-glycosylation should prompt suspicion for AL amyloidosis and CAD in the appropriate clinical context.
 

摘要翻译： 

基于免疫富集的基质辅助激光解吸电离飞行时间质谱（MALDI-TOF-MS），即MASS-FIX技术，在血清单克隆蛋白的检测与分型方面较免疫固定电泳具有多项优势，包括更高的灵敏度与特异性、区分治疗性单克隆抗体的能力，以及快速识别轻链（LC）N-糖基化。我们收集了自2018年以来在本机构接受MASS-FIX检测的6315例患者。其中，4118例（65%）患有各类浆细胞疾病（包括临床意义罕见的单克隆丙种球蛋白病）的患者MASS-FIX检测呈阳性。在MASS-FIX阳性患者中，221例（5%）存在轻链N-糖基化证据；与其他浆细胞疾病相比，该现象更常见于IgM重链亚型、κ轻链亚型，以及在免疫球蛋白轻链（AL）淀粉样变性和冷凝集素病（CAD）的诊断中。这项横断面研究描述了常规临床实践中接受MASS-FIX检测的最大患者队列。我们的研究结果证明了该检测技术的广泛实用性，并证实轻链N-糖基化在相应临床背景下应引起对AL淀粉样变性和CAD的警惕。

原文链接：

MASS-FIX for the detection of monoclonal proteins and light chain N-glycosylation in routine clinical practice: a cross-sectional study of 6315 patients