Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: A systematic review and meta-analysis

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 valu...

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Vydáno v:Multiple sclerosis Ročník 29; číslo 2; s. 169
Hlavní autoři: Hegen, Harald, Walde, Janette, Berek, Klaus, Arrambide, Georgina, Gnanapavan, Sharmilee, Kaplan, Batia, Khalil, Michael, Saadeh, Ruba, Teunissen, Charlotte, Tumani, Hayrettin, Villar, Luisa M, Willrich, Maria Alice V, Zetterberg, Henrik, Deisenhammer, Florian
Médium: Journal Article
Jazyk:angličtina
Vydáno: England 01.02.2023
Témata:
Biomarkers - cerebrospinal fluid
Demyelinating Diseases
Humans
Immunoglobulin G - cerebrospinal fluid
Immunoglobulin kappa-Chains - cerebrospinal fluid
Multiple Sclerosis - cerebrospinal fluid
Multiple Sclerosis - diagnosis
Oligoclonal Bands - cerebrospinal fluid
intrathecal fraction
multiple sclerosis
meta-analysis
diagnosis
index
Cerebrospinal fluid
kappa free light chains
biomarker
systematic review
clinically isolated syndrome
ISSN:1477-0970, 1477-0970
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Shrnutí: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.
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ISSN:1477-0970
1477-0970
DOI:10.1177/13524585221134213