Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis : A systematic review and meta-analysis
Hegen, Harald (Medical University of Innsbruck)
Walde, Janette (University of Innsbruck)
Berek, Klaus (University of Innsbruck)
Arrambide, Georgina (Hospital Universitari Vall d'Hebron)
Gnanapavan, Sharmilee (Queen Mary University of London)
Kaplan, Batia (Sheba Medical Center (Israel))
Khalil, Michael (Medical University of Graz)
Saadeh, Ruba (Clínica Mayo)
Teunissen, Charlotte E (Vrije Universiteit)
Tumani, Hayrettin (University of Ulm)
Villar, Luisa M (Hospital Universitario Ramón y Cajal (Madrid))
Willrich, Maria Alice V (Clínica Mayo)
Zetterberg, Henrik (Sahlgrenska University Hospital (Suècia))
Deisenhammer, Florian
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Intrathecal immunoglobulin-G synthesis is a hallmark of multiple sclerosis (MS), which can be detected by oligoclonal IgG bands (OCB) or by κ-free light chains (κ-FLC) in cerebrospinal fluid. To perform a systematic review and meta-analysis to evaluate whether κ-FLC index has similar diagnostic value to identify patients with clinically isolated syndrome (CIS) or MS compared to OCB, and to determine κ-FLC index cut-off. PubMed was searched for studies that assessed diagnostic sensitivity and specificity of κ-FLC index and OCB to discriminate CIS/MS patients from control subjects. Two reviewers following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines performed study eligibility assessment and data extraction. Findings from studies were analyzed with bivariate mixed models. A total of 32 studies were included in the meta-analysis to evaluate diagnostic value of κ-FLC index. Sensitivity and specificity ranged from 52% to 100% (weighted average: 88%) and 69% to 100% (89%) for κ-FLC index and from 37% to 100% (85%) and 74% to 100% (92%) for OCB. Mean difference of sensitivity and specificity between κ-FLC index and OCB was 2 and −4 percentage points. Diagnostic accuracy determined by mixed models revealed no significant difference between κ-FLC index and OCB. A discriminatory cut-off for κ-FLC index was determined at 6. 1. The findings indicate that κ-FLC index has similar diagnostic accuracy in MS as OCB.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Cerebrospinal fluid ; Kappa free light chains ; Multiple sclerosis ; Clinically isolated syndrome ; Diagnosis ; Biomarker ; Index ; Intrathecal fraction ; Meta-analysis ; Systematic review
Publicat a:	Multiple sclerosis, Vol. 29 (december 2022) , p. 169-181, ISSN 1477-0970

DOI: 10.1177/13524585221134213
PMID: 36453167

13 p, 1.9 MB

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