【摘要】 浆细胞疾病是以血或尿分泌单克隆免疫球蛋白(M蛋白)为特点的一组疾病,肿瘤特征显著。单克隆免疫球蛋白与肿瘤负荷及疾病缓解程度相关,是浆细胞疾病诊断、疗效评估、危险分层、疾病监测、预后判断的重要血清学指标。目前,血清蛋白电泳、免疫固定电泳和血清游离轻链是单克隆免疫球蛋白鉴别及分型的重要方法,但上述方法不能精确检测微小残留病灶,而血清重轻链检测对检出微小残留病灶具有高敏感性,成为浆细胞疾病诊疗的新型检测手段。血清重轻链(HLC)检测可特异性测定重链及轻链相关的完整免疫球蛋白水平,进而推算出HLC比值。本文就HLC比值及"HLC对抑制"对于浆细胞疾病的早期诊断、判断预后、危险分层、检测微小残留及指导用药方面的作用和价值作一综述。更多还原

【Abstract】 Plasma cell proliferative disorders is a group of diseases characterized by monoclonal immunoglobulin secreted in blood or urine,with tumor characteristics significantly.Monoclonal immunoglobulin is an important serological ′tumor′ maker for plasma cell disease diagnosis,efficacy evaluation,risk stratification,disease monitoring and prognosis,which is not only related to tumor load,but also can reflect the degree of disease remission.Currently,serum protein electrophoresis,immunofixation electrophoresis and serum free light chain are important methods for monoclonal immunoglobulin identification and typing,but these methods are difficult to accurately detect minimal residual disease(MRD).Heavy/light chain(HLC) recognizes immunoglobulins with specific heavy/light chain isotypes.The HLC ratio can be calculated through immunoglobulin quantitation by using isotype-specific light chains,which is between an involved monoclonal immunoglobulin and an uninvolved background polyclonal immunoglobulin.A novel immunoassay involving HLC has been applied to plasma cell proliferative disorders and the sensitivity of HLC assay detection of MRD improved significantly.This review discuss the role and value of HLC ratio and HLC-pair suppression in the early diagnosis,prognosis,risk stratification,minimal residual disease monitoring and treatment of plasma cell disease.更多还原