Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study.
- Leurs CE Department of Neurology, MS Center Amsterdam, VU University Medical Center, De Boelelaan 1118, Amsterdam 1081 HZ, The Netherlands.
- Twaalfhoven H Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.
- Lissenberg-Witte BI Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.
- van Pesch V Department of Neurology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Sint-Lambrechts-Woluwe, Belgium.
- Dujmovic I Clinic of Neurology, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia.
- Drulovic J Clinic of Neurology, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia.
- Castellazzi M Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.
- Bellini T Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.
- Pugliatti M Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.
- Kuhle J Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland.
- Villar LM Department of Immunology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain/ Red Española de Esclerosis Múltiple (REEM), Madrid, Spain.
- Alvarez-Cermeño JC Red Española de Esclerosis Múltiple (REEM), Madrid, Spain/Department of Neurology, Hospital Ramón y Cajal, IRYICIS, Madrid, Spain.
- Alvarez-Lafuente R Red Española de Esclerosis Múltiple (REEM), Madrid, Spain/Grupo de Investigación de Esclerosis Múltiple, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain.
- Hegen H Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
- Deisenhammer F Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
- Walchhofer LM Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
- Thouvenot E Department of Neurology, CHU Nîmes, Hôpital Caremeau, Nîmes, France/Institut de Génomique Fonctionnelle, UMR5203, Université Montpellier, Montpellier, France.
- Comabella M Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Montalban X Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Vécsei L Department of Neurology, University of Szeged, Szeged, Hungary/MTA-SZTE Neuroscience Research Group, Szeged, Hungary.
- Rajda C Department of Neurology, University of Szeged, Szeged, Hungary.
- Galimberti D Multiple Sclerosis Centre, University of Milan, Dino Ferrari Centre, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy.
- Scarpini E Multiple Sclerosis Centre, University of Milan, Dino Ferrari Centre, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy.
- Altintas A Koc University, School of Medicine, Neurology Department, Istanbul, Turkey.
- Rejdak K Department of Neurology, Medical University of Lublin, Lublin, Poland.
- Frederiksen JL Department of Neurology, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark.
- Pihl-Jensen G Department of Neurology, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark.
- Jensen P Danish Multiple Sclerosis Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
- Khalil M Department of Neurology, Medical University of Graz, Graz, Austria.
- Voortman MM Department of Neurology, Medical University of Graz, Graz, Austria.
- Fazekas F Department of Neurology, Medical University of Graz, Graz, Austria.
- Saiz A Center of Neuroimmunology, Service of Neurology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain.
- La Puma D Center of Neuroimmunology, Service of Neurology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain.
- Vercammen M Department of Laboratory Medicine, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium.
- Vanopdenbosch L Department of Neurology, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium.
- Uitdehaag B Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.
- Killestein J Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.
- Bridel C Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.
- Teunissen C Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.
- 2019-05-09
Published in:
- Multiple sclerosis (Houndmills, Basingstoke, England). - 2020
English
OBJECTIVE
To validate kappa free light chain (KFLC) and lambda free light chain (LFLC) indices as a diagnostic biomarker in multiple sclerosis (MS).
METHODS
We performed a multicenter study including 745 patients from 18 centers (219 controls and 526 clinically isolated syndrome (CIS)/MS patients) with a known oligoclonal IgG band (OCB) status. KFLC and LFLC were measured in paired cerebrospinal fluid (CSF) and serum samples. Gaussian mixture modeling was used to define a cut-off for KFLC and LFLC indexes.
RESULTS
The cut-off for the KFLC index was 6.6 (95% confidence interval (CI) = 5.2-138.1). The cut-off for the LFLC index was 6.9 (95% CI = 4.5-22.2). For CIS/MS patients, sensitivity of the KFLC index (0.88; 95% CI = 0.85-0.90) was higher than OCB (0.82; 95%CI = 0.79-0.85; p < 0.001), but specificity (0.83; 95% CI = 0.78-0.88) was lower (OCB = 0.92; 95% CI = 0.89-0.96; p < 0.001). Both sensitivity and specificity for the LFLC index were lower than OCB.
CONCLUSION
Compared with OCB, the KFLC index is more sensitive but less specific for diagnosing CIS/MS. Lacking an elevated KFLC index is more powerful for excluding MS compared with OCB but the latter is more important for ruling in a diagnosis of CIS/MS.
To validate kappa free light chain (KFLC) and lambda free light chain (LFLC) indices as a diagnostic biomarker in multiple sclerosis (MS).
METHODS
We performed a multicenter study including 745 patients from 18 centers (219 controls and 526 clinically isolated syndrome (CIS)/MS patients) with a known oligoclonal IgG band (OCB) status. KFLC and LFLC were measured in paired cerebrospinal fluid (CSF) and serum samples. Gaussian mixture modeling was used to define a cut-off for KFLC and LFLC indexes.
RESULTS
The cut-off for the KFLC index was 6.6 (95% confidence interval (CI) = 5.2-138.1). The cut-off for the LFLC index was 6.9 (95% CI = 4.5-22.2). For CIS/MS patients, sensitivity of the KFLC index (0.88; 95% CI = 0.85-0.90) was higher than OCB (0.82; 95%CI = 0.79-0.85; p < 0.001), but specificity (0.83; 95% CI = 0.78-0.88) was lower (OCB = 0.92; 95% CI = 0.89-0.96; p < 0.001). Both sensitivity and specificity for the LFLC index were lower than OCB.
CONCLUSION
Compared with OCB, the KFLC index is more sensitive but less specific for diagnosing CIS/MS. Lacking an elevated KFLC index is more powerful for excluding MS compared with OCB but the latter is more important for ruling in a diagnosis of CIS/MS.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1177/1352458519845844
- PMID 31066634
- Persistent URL
- https://sonar.ch/global/documents/2655
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