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《Chinese Journal of Clinical Medicine》 2017-03
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Establishment of medical reference ranges of serum free light chain ratio in Shanghai population and its diagnostic value on PCN

CHEN Nan;WU Jiong;SHAO Wen-qi;XU Wen;LIU Xiao-wen;WU Bo-ting;CHEN Pu;ZHU Jian-feng;GUO Wei;PAN Bai-shen;Department of Clinical Laboratory Medicine,Zhongshan Hospital,Fudan University;Department of Transfusion,Zhongshan Hospital,Fudan University;  
Objective:To establish the reference ranges of serum free light chain ratio(sFLC-R)in Shanghai,and to study the preliminary clinical significance of sFLC-R for plasma cell neoplasm(PCN)diagnosis.Methods:Sixty-five healthy individuals undergoing ordinary health examinations in Zhongshan Hospital,Fudan University were recruited as the healthy group;29patients with kidney disease as the kidney disease group;27patients with PCN as the PCN group.All participants enrolled received the serum-free kappa and lambda light chain detection,and sFLC-R was calculated for further analysis.Results:The reference range of serum free light chain ratio was 0.54-1.15(97.5%conference interval).The concentrations ofκandλFLC in kidney disease group were higher than those in healthy group(P0.05).The abnormalities ratios of sFLC had a slight difference from that of the disease group,but the difference of the sFLC-R abnormalities ratios was quite apparent.The majority sFLC-Rs in PCN group were outside the reference range,especially the increase ofλ FLC.Conclusions: The concentration of serum-free light chain could reflect the dynamic process of plasma cell production and renal excretion,and sFLC could increase in either plasma cell proliferation or decreased glomerular filtration situations.However,sFLC-R only showed significant changes under the situations in which expressions of either immunoglobulin or light chain were restricted,but remained normal when glomerular filtration decreased.Therefore,the detection of sFLC-R could be a promising tool for early diagnosis and differential diagnosis of plasma cell diseases.
【Fund】: 国家自然科学基金(81572064);; 上海市卫生计生系统重要薄弱学科建设项目(2015ZB0201)~~
【CateGory Index】: R730.43;R733
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