化学
血清蛋白电泳
多发性骨髓瘤
质谱法
浆细胞瘤
浊度法
免疫固定
淀粉样变性
淀粉样变性
不确定意义的单克隆抗体病
色谱法
免疫球蛋白轻链
医学
单克隆
抗体
内科学
单克隆抗体
免疫学
作者
Nikita Mehra,Gopal Gopisetty,Subramani Jayavelu,Sariga Dhanasekar,R Arivazhagan,Jayachandran Perumal Kalaiyarasi,Parathan Karunakaran,Krishnarathinam Kannan,Rajaraman Swaminathan,Thangarajan Rajkumar
标识
DOI:10.1177/00045632231174144
摘要
Background Several studies have demonstrated the analytical sensitivity of MALDI-TOF mass spectrometry (MALDI-TOF MS) by immunoenrichment for M-protein analysis. We report the results of a novel, low-cost, reagent-based extraction process using acetonitrile (ACN) precipitation to enrich for κ and λ light chains which can be analysed by MALDI-TOF MS. Methods Institutional Ethics committee approval was obtained. Serum samples from patients with monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma (MM), plasmacytoma, AL amyloidosis and Waldenström macroglobulinemia (WM) underwent ACN precipitation. The images obtained were overlaid on apparently healthy donor serum samples to confirm the presence of M-protein. A sample was considered positive for M-protein if there was a sharp or broad peak within the κ or λ mass/charge ( m/z) range: m/z- [M + 2H] 2+ : 11,550–12,300 Da and λ m/z- [M + 2H] 2+ : 11,100–11,500 Da. Images were acquired at a m/z range of 10,000–29,000 Da. Corresponding serum protein electrophoresis (SPEP), serum immunofixation electrophoresis (IFE) and serum free light chain (sFLC) assay by nephelometry were performed for all the samples. Results Two-hundred-and-two serum samples were included in the study: MM- 184 (91%); AL amyloidosis- 2 (1%); plasmacytoma- 8 (4%); MGUS- 6 (3%) and WM- 2 (1%). All the SPEP positive samples were identified by MALDI-TOF MS. Out of 179 samples positive for M-protein by IFE, MALDI-TOF MS was positive in 176 samples (98%). Compared to IFE, the sensitivity and specificity of M-protein identification by MALDI-TOF MS were 98.3% and 52.2%, respectively. Conclusions This study demonstrates the feasibility of qualitatively identifying M-protein without the need for antibody-based immunoenrichment, making the technique cost-effective.
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