血清游离轻链在多发性骨髓瘤中的临床意义研究  

Clinical Significance of Serum Free Light Chain in Patients with Multiple Myeloma

作　　者：张森森[1] 吴霜[1] 屈晓燕[1] 许戟[1] 刘澎[1] 陆化[1] 吴汉新[1] 许家仁[1] 李建勇[1] 陈丽娟[1] 

机构地区：[1]南京医科大学第一附属医院,江苏省人民医院血液科,江苏南京210029

出　　处：《中国实验血液学杂志》2013年第4期930-935,共6页Journal of Experimental Hematology

基　　金：国家自然科学基金(编号30971294;81071946;81241074);江苏省自然科学基金(编号BK2008465);江苏省"333"工程项目(编号BRA2011217);江苏省医学重点人才(编号RC2011048);江苏省六大高峰人才(2009);教育部留学回国人员基金(2012);江苏省卫生厅面上科研项目(编号H200932);科技部卫生行业公益性研究重大专项(编号201002024);卫生部部属(管)医院临床学科重点项目(编号2010-2012)

摘　　要：多发性骨髓瘤患者(MM)因浆细胞克隆性增生致血清中产生大量单克隆游离轻链。血清游离轻链(serumfree light chain,sFLC)检测在浆细胞疾病(plasma cell dyscrasias,PCD)的应用中日益突出。免疫比浊法检测sFLC是一种敏感度高、特异性强的快速自动、定量的检测手段。本研究探讨多发性骨髓瘤中sFLC水平并分析多发性骨髓瘤中sFLC与血清总轻链(sTLC)相关性。应用免疫散射比浊法测定明确诊断的45例多发性骨髓瘤初诊患者的血清游离κ及游离λ浓度,计算游离κ及游离λ的比值,评价sFLC在多发性骨髓瘤患者中的临床意义。结果表明,MM患者的sFLC及其比值与正常人具有明显统计学差异(tκ=13.53,P<0.001;tλ=17.53,P<0.001;tκ/λ=4.26,P<0.001);MM患者的sFLC和sTLC及二者的比值间无明显相关性。结论:MM患者中sFLC水平明显高于正常人,sFLC及其比值可作为MM的诊断指标之一。sTLC的测定不能代替sFLC。Multiple myeloma（MM） is a malignant disorder characterized by the proliferation of a single clone of plasma cells that can produce excessive amounts of serum free light chain（sFLC）.sFLC plays an important role in MM diagnosis and disease monitoring.The quantitative immuno-nephelometric assay is sensitive and specific means for sFLC testing.The aim of this study was to investigate the levels of sFLC in multiple myeloma and the relationship between sFLC and serum total light chain（sTLC）.sFLC in 45 newly diagnosed patients were detected by immuno-nephelometric assay,and then the ratio of free kappa to free lambda for every sample was calculated.Meanwhile,sTLC was also determined in these patients.The results showed that the difference of sFLC levels between MM patients and the normal controls was significant（tκ=8.86,P〈0.001;tλ=15.48,P〈0.001;tκ/λ=5.54,P〈0.005）.No correlation between sFLC and sTLC was found in MM patients.It is concluded that the level of sFLC in MM patients is significantly higher than that in normal controls.sFLC and its ratio may be searved as a indicator for diagnosis of MM.sTLC can not replace the role of sFLC.

关 键 词：多发性骨髓瘤 血清游离轻链 血清总轻链 免疫球蛋白 

分 类 号：R733.3[医药卫生—肿瘤]