Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Dokumenter

  • C. E. Leurs
  • H. A. M. Twaalfhoven
  • B. I. Lissenberg-Witte
  • V. van Pesch
  • I. Dujmovic
  • J. Drulovic
  • M. Castellazzi
  • T. Bellini
  • M. Pugliatti
  • J. Kuhle
  • L. M. Villar
  • J. C. Alvarez-Cermeño
  • R. Alvarez-Lafuente
  • H. Hegen
  • F. Deisenhammer
  • L. M. Walchhofer
  • E. Thouvenot
  • M. Comabella
  • X. Montalban
  • L. Vécsei
  • C. Rajda
  • D. Galimberti
  • E. Scarpini
  • A. Altintas
  • K. Rejdak
  • G. Pihl-Jensen
  • P. E. H. Jensen
  • M. Khalil
  • M. M. Voortman
  • F. Fazekas
  • A. Saiz
  • D. La Puma
  • M. Vercammen
  • L. Vanopdenbosch
  • B. M. J. Uitdehaag
  • J. Killestein
  • C. Bridel
  • C. Teunissen

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.

OriginalsprogEngelsk
TidsskriftMultiple Sclerosis Journal
Vol/bind26
Udgave nummer8
Sider (fra-til)912-923
Antal sider12
ISSN1352-4585
DOI
StatusUdgivet - 2020

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