Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (1277 page)

   UPEP testing is subsequently required to detect progression and to monitor response to therapy in patients who have urinary monoclonal proteins at baseline.

   UPEP (and immunofixation) has been used also as a standard screening test for patients in whom there is clinical suspicion for a monoclonal plasma cell proliferative disorder such as myeloma or primary amyloidosis. The serum free light chain assay can be used as an alternative method.

   Quantitative determination of M-protein is useful in the response to chemotherapy or progression of disease.

   Interpretation

Increased In

   Various proteinuria states

   Monoclonal plasma cell proliferative disorders such as myeloma or primary amyloidosis

   Limitations

   The 24-hour urine specimen requires no preservative and may be kept at room temperature during collection.

   Immunofixation should be performed in these patients even if the routine urine analysis is negative for protein, 24-hour urine protein concentration is within normal limits, and electrophoresis of a concentrated urine specimen shows no globulin peak.

   If the patient has nephrotic syndrome, the presence of a monoclonal light chain strongly suggests either primary amyloidosis (AL) or light chain deposition disease in almost all instances.

UROVYSION™ FISH FOR BLADDER CANCER
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   Definition

   The UroVysion™ FISH test for bladder cancer is designed to detect, in cells shed into urine, the presence of aneuploidy for chromosomes 3, 7, 17, and loss of the 9p21 locus, using fluorescence in situ hybridization. These chromosomal abnormalities are commonly associated with urothelial carcinoma.

   Reference ranges: