在对外围神经病变的评估中,常规单克隆性乳腺病变检测的临床实用性
Mackenzie D Maberry1, Caleb J Smith2, Ronald S Go3
1Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Journal of general internal medicine
|May 16, 2025
概括
针对外围神经病变的常规单克隆蛋白质测试具有较低的临床效用. 虽然超过10%的患者被诊断患有意义不明的单克隆性胃病变 (MGUS),但不到1%的患者患有神经病变.
科学领域:
- 神经学 神经学
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 周围神经病变通常通过单克隆蛋白质检测进行评估.
- 关于这种神经病变检测的诊断效用,目前的数据有限.
- 未确定的意义 (MGUS) 诊断的单克隆性胃病变会引起类似于骨髓瘤的焦虑.
研究的目的:
- 量化单克隆蛋白质测试的临床实用性.
- 评估其在神经病变早期恶性瘤检测中的作用.
- 为了确定测试是否识别了外围神经病变的病因.
主要方法:
- 在2021年对1436名接受单克隆蛋白质神经病变检测的患者进行了回顾性审查.
- 排除了37名先前被诊断为单克隆性牙病的患者.
- 临床实用性由新的淋巴细胞瘤瘤诊断或归因于已确定的单克隆性胃病变的神经病变来定义.
主要成果:
- 在1399名测试患者中,10.6%的患者被诊断出单克隆性胃病变,主要是MGUS (98.6%).
- 神经病变仅在0.8% (12名患者) 的病例中被归因于单克隆性胃病变.
- 根据测试结果,在0.1% (2名患者) 的患者中诊断出了淋巴细胞性恶性瘤.
结论:
- 常规单克隆蛋白质测试显示,对外围神经病变评估的临床有用性较低.
- 测试的表现对于神经病变没有其他指示性症状的表现很差.
- 测试应保留在其他诊断被排除在外的情况下.
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