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目的分析52例轻链型多发性骨髓瘤(MM)患者的实验室检查特征,进一步提高对该型疾病实验室诊断的认识。方法利用免疫固定技术从418例M蛋白阳性患者中筛选出在血清和(或)尿中仅出现游离轻链(轻链型M蛋白)的MM患者52例,回顾性分析其血清免疫球蛋白定量、免疫固定电泳、血清蛋白电泳、尿液本-周蛋白定性及尿蛋白定性等实验室结果特征。结果418例血清和(或)尿中出现M蛋白的患者中被确诊为MM的有308例,其中轻链型52例MM(κ型24例、λ型28例)占MM的16.9%。κ轻链型与λ轻链型两组免疫球蛋白IgG、IgA和IgM结果与正常对照组相比较明显偏低(P<0.01);两种轻链结果中,与相对应分型的轻链结果增高,另一种降低;患者血清蛋白电泳光密度扫描曲线多不显示高而窄的单株峰,仅在凝胶片的区带中α2-γ区见一淡染条带,甚至不显示;52例患者尿本-周蛋白定性全部呈阳性,有1例患者血清检测不到轻链M蛋白,但其尿本-周蛋白呈强阳性。结论利用高灵敏度的免疫固定技术对MM患者血清和尿液进行检测其游离轻链,同时结合患者的血清免疫球蛋白等实验结果,能提高其诊断效率。
Objective To analyze the laboratory features of 52 patients with mild-type multiple myeloma (MM) and to further improve the understanding of laboratory diagnosis of this disease. Methods Immunoblotting was used to screen 52 patients with M (MM) who appeared only free light chain (M chain) in serum and / or urine from 418 M protein positive patients. The serum immunoglobulin quantitation , Immobilized Electrophoresis, Serum Protein Electrophoresis, Urine Benign-Zhou Protein Characterization and Urine Protein Qualification Laboratory Results Characteristics. Results There were 308 patients diagnosed as MM in 418 serum and / or urine samples. Among them, 52 MM patients with light chain type (24 in κ and 28 in λ) accounted for 16.9% of MM. The results of immunoglobulin IgG, IgA and IgM in κ light chain and λ light chain group were significantly lower than those in normal control group (P <0.01). In the two light chain results, The results increased, and the other decreased; patient serum protein electrophoresis optical density scanning curve does not show more than tall and narrow single plant peak, only in the strip of α2-γ area to see a lightly stained band, do not even show Urine-peripherin was positive in all 52 patients. One patient had undetectable light chain M protein in the serum, but its urine-peripherin was strongly positive. Conclusion The high sensitivity of immunostaining technique can be used to detect the serum and urine of patients with MM with free light chain. Combined with the serum immunoglobulin in patients, the diagnostic efficiency can be improved.