Proposed Method Using the Urinary Albumin-To-Total Protein Ratio for Detection of Urinary Bence Jones Protein

Area of Science:

• Biochemistry
• Clinical Diagnostics
• Oncology

Background:

• Urinary Bence Jones protein (BJP) detection is crucial for early diagnosis of malignancies such as multiple myeloma.
• Current detection methods (heat coagulation, IEP, IFE) have limitations including low sensitivity, high cost, and labor intensity.
• There is a need for alternative, more accessible biomarkers for urinary BJP.

Purpose of the Study:

• To evaluate the utility of the urinary albumin/total protein (U-ALB/U-TP) ratio for the early detection of urinary BJP.
• To establish a novel diagnostic marker for malignant diseases characterized by BJP excretion.

Main Methods:

• Measured U-ALB and U-TP in 85 confirmed BJP urine samples and 507 general patient samples.
• Calculated the U-ALB/U-TP ratio for 592 samples.
• Utilized receiver operator characteristic (ROC) curve analysis to determine the optimal cutoff value for BJP detection.

Main Results:

• A strong correlation between U-TP and U-ALB was observed in the general patient group, but a weak correlation in the BJP group.
• ROC curve analysis identified a U-ALB/U-TP ratio cutoff of 0.362 with an area under the curve of 0.941.
• At a U-TP threshold of ≥ 30 mg/dL, the U-ALB/U-TP ratio achieved 92% sensitivity and 88% specificity for BJP detection.

Conclusions:

• The U-ALB/U-TP ratio can effectively detect urinary BJP.
• This ratio serves as a promising biomarker for the early, presymptomatic detection of malignant diseases associated with BJP.
• The U-ALB/U-TP ratio offers a potentially simpler and more accessible method for identifying patients requiring further investigation for serious conditions.