实验室检查在多发性骨髓瘤临床诊断中的价值  

Value of laboratory data in the clinical diagnosis of multiple myeloma

作　　者：肖敏敏[1] 陈健康[1] 徐小明[1] 

机构地区：[1]安徽省芜湖市第二人民医院检验科,安徽芜湖241000

出　　处：《安徽医药》2012年第1期75-77,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的了解各种实验室检查在多发性骨髓瘤(MM)临床诊断中的价值。方法对2007年2月～2011年2月临床诊断为多发性骨髓瘤的26例患者血清蛋白电泳、免疫固定电泳、血清总蛋白、免疫球蛋白及尿本-周氏蛋白、骨髓细胞学检测结果进行回顾性分析。结果血清蛋白电泳分析发现26例MM均检出M带,免疫固定电泳结果显示:IgG型16例(61.5%),为最多类型,其中IgGκ型10例(38.5%),IgGλ型6例(23.1%);IgA型7例(26.9%),其中IgAκ型5例(19.2%),IgAλ型2例(7.7%);IgM型1例(3.8%),为κ型;轻链型2例(7.7%),均为λ型。IgG型M带多出现在γ区,IgA型M带多出现在在β区。各类型M蛋白阳性患者对应Ig的血清浓度均显著升高;轻链型各种Ig含量均降低。23例血清总蛋白升高。26例尿本-周氏蛋白检测均为阴性。16例行骨髓细胞学检查的患者14例骨髓浆细胞质与量的改变均符合诊断标准。结论血清总蛋白、免疫球蛋白检测对临床诊断MM具有重要的提示作用;血清蛋白电泳因其灵敏度高、速度快且图谱清晰直观,是很好的M蛋白临床筛查实验;免疫固定电泳因其特异性好、灵敏度高,对MM的诊断分型和临床分期具有重要意义。Objective To study the values of laboratory data in the clinical diagnosis of multiple myeloma（MM）.Methods Serum protein electrophoresis（SPE）,immunofixation electrophoresis（IFE）,serum total protein,globulin,urine B-J protein results of 26 MM patients diagnosed during February 2007 to February 2011 were reviewed.Results M protein was detected in all of 26 cases with SPE.IFE manifested that：there were IgG kappa 10 cases（38.5%）,IgG Lambda 6 cases（23.1%）,IgA kappa 7 cases（26.9%）,IgA Lambda 5 cases（19.2%）,IgM Lambda 1 case（3.8%）,and Lambda light chain 2 cases（7.7%）.M proteins of IgG type were mostly detected in γ region,while those of IgA type were mostly detected in β region.Except for light chains in which all types of immunoglobin were lower than normal,the immunoglobin of other types of M protein were distinguished high respectively.All B-J protein tests were negative.14 among 16 cases with bone marrow morphology tests were up to standard of MM.Conclusion Serum protein tests can be used as a suggestion of MM.SPE was simple and quick method with high sensitivity for screening MM.IFE was suitable for identifying and typing MM with high specificity and sensitivity.

关 键 词：多发性骨髓瘤 血清蛋白电泳 免疫固定 免疫球蛋白 M蛋白 

分 类 号：R733.3[医药卫生—肿瘤]