Bens Jones protein is not present in the urine of a healthy person. In most cases, its concentration in urine indicates multiple myeloma (more often diagnosed in older men). Jones protein can only be detected in laboratory tests.

Bens Jones protein in urine is a marker that indicates an oncological pathology in the human body (it develops in the bone marrow region). Proteins of this type are proteins that are produced by plasma cells. Bens Jones urine protein analysis is an additional research method that is prescribed to patients with suspected growth of malignant neoplasms.

This protein should not be found in the urine of a healthy person.

A tumor marker is detected by a laboratory method. The patient's urine heats up and the Jones' protein settles after the liquid is boiled. The method is named after a famous English chemist and scientist. He found a high concentration of this protein when he examined the urine of patients with suspected multiple myelomas.

Jones protein can only be detected when the urine is oxidized, then it is passed through a filtration system and heated. After the precipitate is separated, washed and weighed. In most cases, suspicions of multiple myeloma are confirmed upon detection of a pathological protein. Similar results may indicate leukemia, lymphosarcoma, and osteomalacia.

Indications

Bens Jones protein urine is a test that the patient is referred to by a doctor who specializes in cancer and also by a urologist. The patient undergoes this type of examination only if the doctor suspects the presence of plasma cells that cause bone destruction, myeloma, bone cancer (rapidly progressive) and some other diseases.

As noted earlier, the urine of a completely healthy person should not contain this type of protein. Its basis is immunoglobulin light chains. The compound is carried throughout the body, enters the organs of the urinary system and is excreted from the body. Determination of Bens Jones protein in urine may indicate the following diseases:

• lymphatic leukemia;
• myeloma (characterized by the formation of tumors in the bone marrow);
• violation of protein metabolism in the body (primary amyloidosis);
• cancer localized to the spleen, liver, bone marrow, and lymph nodes (chronic lymphocytic leukemia);
• pathological processes affecting the blood vessels.

According to medical research, Bens Jones proteinuria interferes with kidney function. When the protein is secreted by the organs of the genitourinary system, toxic substances pass along with it through the channels. This negatively affects the tissue of the renal tubules. Against this background, the patient can be diagnosed with either dystrophy.

Analysis rules

The test results depend on the patients' compliance with the doctor's recommendations. There are just a few rules to follow.

It is recommended to exclude meat products and liver from the diet in a few days (preferably a week). You also need to give up carbonated and alcoholic drinks. It is forbidden to eat foods that may even slightly affect the state of urine. For example, when a person eats beets or carrots, the hue of their urine may change slightly.

If the patient is taking any medications, they must also be reported to the attending physician. For the period of preparation and delivery of the analysis, the use of some medicines is prohibited.

Only morning urine is suitable for analysis.

Before collecting the biomaterial, you need to take a shower, but do not use special means for intimate hygiene and soap.

It is best to collect urine in a pre-purchased special container or in a clean glass jar. Before the material is placed in the container, boiling water is poured over it. It is necessary to donate urine to the laboratory no later than 2 hours after collection.

Protein determination

In the laboratory, urine filtrate is mixed with acetate buffer (4: 1 ratio). The resulting liquid is heated using a water bath. At the same time, the protein begins to settle, which makes it possible to determine its concentration.

Lab technicians can also use the immunoelectrophoretic method. For this purpose, special serums are used. They can detect even small amounts of protein. But if there are no symptoms against this background, this is a likely sign that benign monoclonal gammopathy (a pathology in which the body synthesizes defective immunoglobulins) is developing in the body.

With myeloma

Multiple myeloma and a positive urine test for Jones' protein are closely interrelated processes. But it is impossible to diagnose this disease by examining only the results of blood tests, therefore, additional studies are carried out to confirm.

Most often, patients complain of periodic pain in the bones, problems with urination. The body begins to retain fluid. Also, various hematomas may appear on the skin (even after minor exposure). You cannot make a diagnosis based on symptoms, since similar clinical manifestations are often characteristic of other diseases.

According to statistics, myeloma is most often diagnosed in older males.

Doctors also take a close look at the patient's history. Often there is a genetic predisposition to the development of the disease, problems with being overweight (which can serve as an impetus for the development of the disease), poor working and living conditions (the level of exposure to various toxins on the human body is being studied).

For a long time, the disease may not manifest itself in any way. But if the patient regularly takes a blood test, over time it can be noted that the erythrocyte sedimentation rate gradually increases. Signs such as general malaise, a feeling of constant weakness, fatigue, pain in the bones appear only after some time. Treatment of the disease depends on the extent of its spread.

Studies show that in patients with suspected myeloma, protein in the urine is found in 2 cases out of 3, 15-25% of patients are diagnosed with Bens-Jones myeloma.

Conclusion

The concentration of Jones' protein in the urine of a healthy person is very low, therefore it is not determined by conventional tests, that is, the test result is negative. In rare cases, only traces of it can be found in urine.

In 55-60% of cases, protein is detected in patients with a diagnosis of myeloma. This disease is characterized by a long asymptomatic course and is a tumor process in cells that perform immune functions. The material for research (in this case, urine) should be prepared in accordance with the doctor's recommendations. Urine is collected in the morning and delivered in a clean container to the laboratory no later than 2 hours after collection.

Clinical analysis of urine (or general urine analysis) is a frequently used method of laboratory diagnostics to assess the state of human health.

The Bence Jones protein (or Bence Jones protein) should be absent in urine, and its detection is a signal for the development of certain diseases, including cancer.

If the doctor suspects the patient has myeloma or some other disease, he will ask for a urine test for Bens-Jones protein. This is a tumor marker, the presence of which is highly likely to indicate multiple myeloma.

This protein appears when the immune cells start to malfunction and create defective proteins.

The compound itself is a sticky protein of the immune system (immunoglobulins), which are produced in cancer of the bone marrow, less often in other malignant blood diseases.

Proteinuria can appear for other reasons, so a doctor should be involved in the diagnosis.

Indications for the Bens-Jones protein test

Usually, a referral is given by a urologist, hematologist or oncologist. Not all patients undergo a urine test for Bence-Jones protein. The urine of people who are suspected of having malignant blood diseases is sent for analysis.

It is necessary to donate urine to people with suspected amyloidosis. The appearance of the Bens-Jones protein, that is, the adhesion of chains of light immunoglobulins, occurs with Waldenstrom's macroglobulinemia, a rare disease in which an analysis is also prescribed.

The main symptoms that should alert the patient and make the doctor think about myeloma are:

1. Increased fragility of bones. More frequent fractures in the past few months or the appearance of pathological fractures (without a traumatic factor).
2. X-ray picture. All radiologists are aware of the special changes in the bones in patients with myeloma, which appear on the roentgenogram in the form of specific "holes".
3. Unexplained anemia (decreased hemoglobin levels). Its manifestations are typical (weakness, pallor, dizziness, inability to endure physical activity). The patient himself cannot understand the cause of anemia. The doctor, in turn, according to a clinical blood test, may suspect leukemia and regard anemia as its consequence.
4. Thrombocytopenia. In the patient, this is manifested by increased bleeding, more frequent bruising and a slowdown in blood coagulation. In a blood test, pathology will be manifested by a decrease in the number of platelets.
5. Hypercalcemia. An increase in the level of calcium in the blood of more than 2.75 mmol / l. Most often causes brittle bones and kidney stones.
6. Proteinuria. The unexplained appearance of protein in the urine is a reason for visiting a urologist, who may later prescribe additional studies or consultations with other specialists.

How to get a urine sample for Bence Jones protein

Bens-Jones protein urinalysis is not an easy study. Bens-Jones protein urine analysis involves a number of complex manipulations, so laboratory technicians need a properly collected sample.

General rules for collecting urine for Bence-Jones protein determination:

• reduce the consumption of liver and meat a week before the test;
• the day before delivery, exclude carbonated water and drinks, alcohol, fresh bright vegetables and fruits, sometimes the doctor will recommend stopping certain medications;
• prepare a container for collecting urine in advance. It can be a pharmacy disposable container that does not need processing or a glass jar with a metal lid after rinsing with boiling water;
• before collecting urine, wash the genitals without soap and detergents;
• collect an average portion of morning urine with a volume of at least 50 ml (during the first urination after waking up, the first portion of urine must be drained into the toilet, then the main portion must be collected in a container, and end urination not in a jar);
• tightly close the container and deliver it to the laboratory within a maximum of two hours (the time can be extended if the collected urine is cooled).

Identifying the Bence Jones protein

Modern methods for the determination of Bens-Jones protein in urine require the use of several complex technologies. At the beginning of the study, all protein is isolated from the biological material.

By electrophoresis, the total protein is separated into fractions depending on the mass of the molecule. The required protein fraction is processed with special whey solutions.

The reaction of an immunoglobulin (an antibody in human blood) with a serum solution (a set of antigens) causes the formation of an immune complex.

Such a connection becomes clearly visible after special staining. Antibody kits are expensive, but they accurately identify the desired protein.

Previously, a different, less reliable method was used. Whole urine was heated to a minimum of 60 degrees Celsius (no more than 80), then cooled to 2-8 ° C, and reheated almost to a boil.

In this case, proteins dissolved in the urine precipitated immediately.

Bens-Jones protein coagulated at a urine temperature of 50-60 degrees, precipitated when cooled, and then dissolved again when heated to boiling point.

Such changes during exposure to temperature made it possible to distinguish it from other protein compounds in urine.

Causes of Bens-Jones protein in urine

Proteinuria is the presence of more than 0.033 g / L of protein in the urine. It can be caused by either kidney disease or abnormal proteins in the blood.

In a healthy person, protein molecules do not pass through the kidney filter from the blood to the urine. Proteinuria appears in such cases:

• disruption of the renal glomeruli (glomeruli), in which the blood is filtered;
• the presence of incorrect proteins in the blood that are not retained by glomeruli;
• infectious diseases of the urinary tract and kidney tubules;
• neoplastic diseases of the kidney or urinary tract;
• the development of renal failure.

Bens-Jones protein appears in urine through the first or second mechanism. The main reason is myeloma.

This is a cancer of the blood, in which the plasma cells of the immune system, instead of the usual antibodies, create paraproteins - abnormal immunoglobulins.

In addition to myeloma, the appearance of paraproteins in the blood is characteristic of Waldenstrom's macroglobulinemia and heavy chain disease.

Healthy plasma cells, or B lymphocytes, create antibodies (immunoglobulins) to destroy foreign proteins.

Atypical (i.e., tumor) plasma cells often synthesize abnormal proteins that are unnecessary for the human body due to their inability to fight infections. These protein molecules can be cleared from the blood by the kidneys.

Many other diseases can be manifested by the appearance of abnormal proteins in the blood and urine. Such diseases include:

• various lymphomas (tumors of the lymphatic system - lymph nodes, spleen);
• various leukemias, they are also leukemias, - malignant diseases of the blood and bone marrow;
• amyloidosis (synthesis and deposition in the organs of a defective protein - amyloid);
• cancerous tumors of the liver;
• osteosarcomas (malignant tumors of bone tissue).

The detection of a pathological protein in urine may be the result of an error. Even modern high-tech research methods have errors.

It is important that the diagnosis is made by a doctor who will be able to evaluate the results of more than just one research method. Any diagnosis should be made on the basis of a combination of symptoms and conclusions after several examinations.

Bens-Jones protein for multiple myeloma

Multiple myeloma belongs to the group of paraproteinemic leukemias, that is, malignant blood diseases with the appearance of incorrect immunoglobulins. This also includes Waldenstrom's macroglobulinemia and heavy chain disease.

As with all diseases of this group, in people with multiple myeloma, B-lymphocytes (plasma cells) synthesize paraproteins found in blood and urine.

Sometimes the protein may be completely absent in urine or not detected due to too low concentration. In the blood, it is almost always there, so a blood test for Bens-Jones protein is more informative.

Bone marrow research is even less common: a puncture (biopsy) of the red bone marrow can detect both atypical plasma cells that create defective immunoglobulins and the protein itself.

The Bence Jones protein is not only a diagnostic indicator. It is a toxic substance that affects kidney function.

Often with myelomas, patients develop nephropathy and renal failure due to damage to the filtration apparatus of the kidney. As a result of this damage, kidney function is impaired, and other toxic substances are retained in the body, rather than excreted in urine.

There are other possible consequences of the harmful effects of paraproteins. In some patients, protein affects the functioning of the endocrine glands (thyroid, pancreas, adrenal glands) and causes an increase in the level of calcium in the blood.

Often, myeloma disrupts blood formation, which leads to anemia (a decrease in hemoglobin levels). There are also bone injuries due to a combination of calcium metabolism disorders with a growing tumor of the bone marrow located inside the large bones.

Finally

The urine Bens-Jones protein test is important for the detection of certain malignant blood diseases. Most often it is myeloma.

A preliminary examination by a urologist, traumatologist, oncologist or hematologist may be the reason for the appointment of such a study.

It is important to pass the analysis in a timely manner in order to detect the disease in time and begin treatment.

If the result is positive, consultation with a hematologist is required!

To identify oncological pathologies, hardware and laboratory diagnostic methods are used. One of the main clinical studies for the presence and development of malignant neoplasms are tumor markers - indicators of tumor growth. They are a set of biomolecules, the content of which in blood or urine increases with the progression of cancer.

In clinical diagnostics, 15–20 types of tumor markers are determined, which correspond to one or another type of tumor and their location in the body. Tumor markers appear in the body earlier than the pronounced symptoms of tumor formations. Timely assessment of their concentration makes it possible to diagnose the disease at the initial stage of development.

Bens Jones protein in urine is an indicator of myeloma - a malignant formation originating from the cells of the hematopoietic tissue of the bone system (plasma cells). In a healthy body, plasma cells are responsible for the formation of immunoglobulins. Under the influence of negative factors, the maturation of plasma cells is disrupted, and a group of tumor cells is formed, synthesizing abnormal proteins, paroproteins.

Important! The urine of a healthy person does not contain the Bens-Jones tumor marker.

About Bens-Jones tumor marker

Any protein is a high-molecular organic substance protein containing alpha-amino acids, united by a peptide bond into a single chain. Due to its low molecular weight, Bens-Jones protein is not retained in the systemic circulation, but penetrates through the blood, directly into the organs of the urinary system, and is excreted from the body in the urine.

Therefore, the presence of a tumor marker, otherwise Bens-Jones proteinuria, is determined in urine, and not in the blood, like most cancer indicators. The severity of the malignant process is assessed by the protein concentration. The low-molecular-weight protein increases the permeability of the renal glomerular filter and damages the tubular epithelium. The process of reabsorption (reabsorption) is disrupted.

During the period when alpha-amino acids are in the urinary system, its molecules harm the walls of the bladder, urethra, and damage the tissues of the renal calyx and pelvis. With its high toxicity, the substance poisons and destroys the kidneys, causing organ dysfunction that threatens the development of renal failure.

In addition to the fact that the Bens-Jones protein is not absorbed by the kidneys, it is able to enter into a correlation with other proteins, which leads to the formation of protein casts from the destroyed epithelium (the so-called casts in the renal tubules), the formation of calculi (stones) in the bladder.

Any proteinuria (the presence of excess protein in the urine) is a sign of glomerular inflammation of the kidneys. The detection of the Bens-Jones protein is a clinical sign of a malignant process. With further diagnosis, it is confirmed in 75% of cases. The protein got its name from the name of the British physician Henry Bens-Jones, who first identified the tumor marker in 1847.

Proteinuria Bence Jones

The definition of Bens-Jones proteinuria primarily indicates multiple myeloma. This tumor is malignant, but not cancer, since it does not originate from tissues, but from plasma cells. The disease has three forms:

• diffuse, damaging the bone marrow;
• diffuse focal, affecting the bone marrow and some other organs (in particular, the kidneys);
• multiple myeloma, which affects the entire body.

Myeloma is characterized by excessive bone fragility, frequent fractures, and pain in the bones. The disease spreads to the renal apparatus, the patient rapidly develops myeloma nephropathy, which leads to renal decompensation.

In addition to multiple myeloma, the detection of Bence-Jones protein in urine may be a sign of the following pathologies:

• fanconi syndrome and renal amyloidosis - diseases characterized by impaired protein metabolism;
• malignant disease of lymphatic tissue, spleen, liver, lymph nodes (lymphocytic leukemia);
• tumor of the hematopoietic and lymphatic system (lymphosarcoma);
• neoplasm of bones, with early manifestation of metastases throughout the body (steosarcoma);
• damage to plasma cells (plasmacytoma);
• malignant degeneration of the endothelium of blood vessels (endotheliosis);
• systemic pathological process associated with impaired bone mineralization (osteomalacia);
• oncology of lymphoid tissue (lymphogranulomatosis);
• malignant tumor of the hematopoietic organs (Waldenstrom's macroglobulinemia).

To accurately confirm each of the possible diagnoses, one urinalysis for Bens-Jones protein is not enough. The patient needs a comprehensive examination.

Indications for the study

Bence Jones urine protein analysis is a specific study that is not performed in every laboratory. A referral for urine collection is prescribed by an oncologist or urologist in case of symptomatic complaints of the patient corresponding to signs of one of the possible oncopathologies.

The study is prescribed for a diagnosed violation of protein-carbohydrate metabolism with extracellular deposition in the renal tissue of a complex protein-polysaccharide compound (amyloid) - amyloid disease of the renal apparatus.

On a regular basis, the analysis is taken from patients with malignant lesions of the bone and lymphatic systems to monitor the dynamics of the therapy. In addition, the study is recommended for people with a dysfunctional family history (cancer in the listed body systems).

Analysis preparation rules

Objective results of urinalysis for the detection of Bens-Jones protein are guaranteed only by compliance with the conditions of preliminary preparation. The patient needs to purchase a special sterile container for urine from the pharmacy. It is convenient, inexpensive, and reliable. It is recommended to change the diet for seven days before passing urine. It is necessary to eliminate protein products (meat and offal, fish, seafood, smoked meats).

For two days, products that have the property of staining urine (beets, asparagus, carrots, rhubarb, blackberries) are excluded from the menu. It is prohibited to drink alcoholic drinks, carbonated water, lemonade. For 2-3 days it is necessary to stop using medications (including multivitamins that change the color and smell of urine).

For women, the ban applies to vaginal contraceptives, medicated suppositories, and douching with antiseptic solutions. On the eve of the test, you should interrupt sports training, exclude physical activity, and avoid hypothermia. It is necessary to collect urine in the morning after waking up. The most accurate research data is provided by an average portion of urine.

To do this, you must first urinate into the toilet, then into the prepared pharmacy container, and then, back into the toilet. For microscopy, 50 ml of urine is enough. Before collecting urine, you should perform a hygiene procedure for the external genital organs. The use of soap or gel is not recommended. For women, the optimal time for testing is the middle of the menstrual cycle.

Before collecting urine, the vagina should be covered with a cotton sponge or tampon to avoid getting the secretions of the vaginal glands into the container. The container with urine must be tightly closed and delivered for examination within two hours. If necessary, the doctor may prescribe a study of the daily urine rate. In this case, all the urine released per day is collected in a container with a capacity of three liters.

Important! Failure to comply with the preparation conditions may distort the study results, as a result of which the wrong treatment will be prescribed.

Laboratory method for protein determination

After filtration and reabsorption in the kidneys, no more than 30–150 mg / day of proteins are determined in the urine, most of which is albumin. This is called microalbuminuria and cannot be detected by routine urinalysis. When the norm is exceeded, proteinuria develops, indicating kidney disease.

Moreover, only the Bens-Jones protein has an oncological nature. With benign paraproteinemia, this substance is not detected in the urine. To detect paraproteins in urine, the technique of electrophoresis is used. With the help of an electrophoretic analysis method, the molecules of protein fractions are grouped by discharges and sizes.

Protein molecules, like any electrically charged particles, move in an electric field, therefore, when a constant voltage is applied to the urine sample, they begin to move: positively charged - to the cathode, negatively charged - to the anode. After the separation of the molecules, serum is added, upon reaction with which the paraproteins are colored. Proteinuria Bens-Jones is manifested by an intense color.

Another method for detecting the Bens-Jones protein is the release of the substance using oxidation and heating. A buffer solution containing sodium acetate and acetic acid (in a 4: 1 ratio) is added to the urine sample, then heated to 60 ° C and cooled. As a result, the protein is transformed into a precipitate, which is washed in alcohol and ether. The final residue is weighed.

Further diagnosis

When Bens-Jones paraprotein is detected, an extensive diagnosis of myeloma is prescribed, including hardware and laboratory research. Hardware procedures include skeletal bone x-rays, MRI (magnetic resonance imaging), spiral CT (computed tomography).

Laboratory diagnostics include:

• General blood analysis. With pathology, a decrease in hemoglobin, the number of platelets, leukocytes, erythrocytes, as well as the presence of plasma cells are recorded.
• Blood biochemistry. There is an increased level of concentration of uric acid, urea and creatinine, hypercalcemia (increased level of calcium).
• Coagulogram. Conducted to assess blood clotting.
• Cytogenetic study of bone marrow cells (plasmacytes). It is necessary to identify chromosomal abnormalities.

The presence of paraprotein in urine means a positive test result, the absence of a negative

Separately, a sampling of bone marrow cells (biopsy) is prescribed to draw up a myelogram - an assessment of the qualitative and quantitative content. Multiple myeloma, in most cases, is diagnosed in men over the age of sixty. The cause of death is not only the development of oncological processes, but also the concomitant renal failure of the progressive course.

The disease, up to a certain point, has an asymptomatic course, which is the main reason for a timely (late) diagnosis. Analysis of urine for the Bens-Jones protein content makes it possible to identify oncopathology at an early stage of development, which significantly increases the chances of effective treatment.

If the test is positive, radiation therapy and chemotherapy (to eliminate malignant cells) are used. As a special therapy, the patient is prescribed medications developed in the laboratory, which are based on monoclonal antibodies that can inhibit tumor growth.

Outcome

Bens-Jones protein is the main laboratory indicator of bone marrow cancer. In a healthy person, this substance is absent in the urine. If the doctor has ordered a urinalysis to test for the presence of Bence Jones protein, there are good reasons for this. It is necessary to collect urine according to the rules of preparation for analysis. This will ensure the maximum objectivity of the research results.

Method of determination Electrophoresis and immunofixation.

Study material Urine (sample of a single morning or daily urine) at least 20 ml

Home visit available

Detection of Bens-Jones protein in urine by electrophoresis and immunofixation.

The Bens-Jones protein is the first of the described tumor markers, and since its discovery by Henry Bens-Jones in 1847 to the present day it has been used as a diagnostic test for multiple myeloma (tumor of plasma cells). The structure of the Bens-Jones protein is represented by polymers with a molecular weight of 22-24 kDa, consisting of free light chains of immunoglobulins. In healthy people, a small amount of free light chains are constantly produced, along with complete immunoglobulin molecules. Due to their low molecular weight and neutral charge, they are filtered into the primary urine through the basement membrane of the glomerulus, then reabsorbed and metabolized in the proximal tubules without entering the final urine. With monoclonal gammopathies, primarily with multiple myeloma, idiopathic primary amyloidosis, less often with Waldenstrom's macroglobulinemia, there is a significant production of abnormal immunoglobulins by a malignant clone of plasma cells. This results in an excess of free light chains in the primary urine and the Bence Jones protein in the final urine.

Bens-Jones protein is found in 2/3 of patients with multiple myeloma. The production of monoclonal total immunoglobulins (usually IgA and IgG) is accompanied by the synthesis of a variable amount of light chains. About 20% of myeloma cases are characterized by the production of exclusively monoclonal light chains (light chain disease). Serum protein electrophoresis usually does not detect Bence-Jones protein, as it is easily excreted in urine, in which it can be detected due to the concentration effect. Determination of Bens-Jones protein in urine has not only diagnostic, but also prognostic value, since its excessive intake into the kidneys has a damaging effect on them, leads to tubular atrophy, pronounced sclerosis of the interstitium of the kidney. The likelihood of such an effect is increased by predisposing factors (dehydration, hypercalcemia, the use of X-ray contrast agents, certain medications), which can lead to irreversible renal failure, which is one of the most formidable manifestations of myeloma.

An especially reliable method for detecting monoclonal light chains in urine is urine protein electrophoresis with immunofixation. Bens-Jones protein using the method of immunofixation can be detected even against the background of minimal proteinuria at the onset of the disease with still unchanged renal function. Performing a screening immunofixation test allows not only to detect the Bens-Jones protein, which is a marker of myeloma, but also to determine its quantitative content, which can be used in the control of therapy. When the Bens-Jones protein is found, it is necessary to type it in order to assess the pathological effect on the kidneys, since the pathogenic effect of the Bens-Jones protein of the lambda type is higher than that of the kappa type protein (see test).

Literature

• Clinical laboratory diagnostics. National leadership: in 2 volumes -T.1. / Ed. V.V. Dolgov, V.V. Menshikov. - M .: GEOTAR-Media. 2012.
• Materials of the manufacturer of reagents.
• Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Ed. Burtis C., Ashwood E., Bruns D. Elsevier Sounders, 4th Edition. 2006.

One of the first created tumor markers indicating oncological pathology in the human body is Bence-Jones protein in urine. The analysis is aimed at identifying an expanding cancer, namely myeloma, a malignant neoplasm growing from plasma cells in the bone marrow. Most people diagnosed with myeloma have a urine Bence-Jones protein test positive. This fact suggests that the tumor marker is indicative for suspected cancer of this type.

The presence of Bens-Jones protein in urine indicates some diseases.

Bens-Jones protein is a protein that appears in the urine due to certain diseases. In medicine, this process is called proteinuria.

Protein is clearly visible in laboratory research, when urine is heated to a temperature of 60 °. At this temperature, it tends to settle. If the liquid is boiled, then the substance will dissolve and then settle again as the urine cools. This ability of the protein distinguishes Bens-Jones proteinuria among other types of proteinuria. The basis of this substance is made up of polymers folded from the light free chains of immunoglobulins.

Bens-Jones amino acid is released during illness, and is observed when urine is heated in laboratory conditions.

It was first discovered by an English scientist, chemist, M.D. Henry Bence-Jones during a chemical study of urine belonging to a patient with multiple myeloma. The oxidation of urine, its subsequent filtration and heating helps to detect Bens-Jones protein bodies. Then the resulting precipitate is separated from the main liquid, washed in water, alcohol, ether, and weighed at the end. In the majority of patients with a positive result for the tumor marker, multiple myeloma is confirmed, however, the presence of such a protein in the urine may also indicate other diseases:

• lymphosarcoma;
• leukemia;
• osteomalacia (pathological soft bones).

Indications for research

Often, a urologist, oncologist or hematologist will send this type of analysis. It is prescribed in case of suspicion in a patient of myeloma, plasmacytoma (a disease of plasma cells that destroys bone tissue), primary ameloidosis (ameloid disorder of protein metabolism), osteosarcoma (rapidly growing bone cancer), chronic lymphocytic leukemia (tumors that involve the bone marrow, liver, spleen and lymphatic nodes), lymphatic leukemia (blood cancer), endotheliosis (damage to blood vessels), lymphogranulomatosis (inflammation of lymphoid tissues).

The analysis requires careful preliminary preparation. Only after completing all the preparations correctly, you can count on the correct result. You need to start cooking a week before the test. During this period, meat dishes, liver are excluded from the diet. The day before the study, remove from the menu all products that can stain stool (carrots, blackberries, beets). It is recommended to refuse carbonated and alcoholic drinks.

They prepare for the Bens-Jones protein test in a week, observing a certain diet.

You need to collect urine in a special sterile container (sold at any pharmacy). If it is not possible to buy a container, then you can take a small glass jar (for example, from under children's fruit puree or mustard). The container should be thoroughly washed, rinsed, dried in advance. In this case, the middle part of the urine is of value. A sample is collected early in the morning like this: the beginning of urination is made into the toilet, the middle portion - into the prepared dishes, the final (urine residues) - back into the toilet.

For the analysis for the Bens-Jones tumor marker, at least 50 ml of the collected fluid will be needed.

Before going to the toilet, the crotch is washed well with water without soap, and wiped dry with a clean towel. It is better for women to take urine for Bens-Jones protein bodies in the middle of the cycle, when she can be sure that menstrual flow will not enter the container along with urine, because this will affect the quality of the analysis. The collected urine should enter the laboratory no longer than 2 hours after taking the analysis.