血清游离轻链检测在多发性骨髓瘤中的应用价值  

Application value of serum free light chain detection in multiple myeloma

作　　者：鲁家才[1] 黄少军[1] 田小龙[1] 周小芬 莫扬[1] 姚欣[1] LU J iacai;HUANG Shaojun;TIAN Xiaolong;ZHOU Xiao fen;MO Yang;YAO Xin(Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Sciences,Xiangyang,441021,China)

机构地区：[1]襄阳市中心医院,湖北文理学院附属医院,湖北襄阳441021

出　　处：《临床血液学杂志（输血与检验）》2018年第6期939-941,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

摘　　要：目的:探讨血清游离轻链(sFLC)检测在多发性骨髓瘤(MM)患者中的变化和临床应用价值。方法:选择116例MM患者,留取初诊和联合化疗后的血清样本,采用免疫散射法测定sFLC,同时应用免疫固定电泳(IFE)检测血清M蛋白,分析sFLC在MM患者诊断和预后中的作用。结果:初诊时116例MM患者sFLC或其比值均有异常改变,且ISSⅢ期患者sFLC水平显著高于ISSⅠ期和Ⅱ期患者,而IFE检测血清M蛋白阳性率为87.3%;联合化疗后血清游离轻链κ或λ水平显著下降(P<0.05),其中有效组患者sFLCκ/λ比值恢复正常为70.2%,进展期患者sFLC水平有明显降低但仍维持较高水平,且sFLCκ/λ比值有2例恢复正常,高sFLC患者可能具有更高的肿瘤负荷和更强的侵袭性,可提示患者预后不良。结论:sFLC检测在MM的早期诊断、疗效评估以及微小肿瘤负荷检测等方面有重要的临床应用价值。Objective:To investigate the changes and clinical application value of serum free light chain(sFLC)detection in patients with multiple myeloma(MM).Method:A total of 116 MM patients were enrolled.Serum samples from the initial diagnosis and combined chemotherapy were used.The sFLC was determined by immunoscopy.The serum M protein was detected by immunofixation electrophoresis(IFE).The role of sFLC in the diagnosis and prognosis of MM patients were analyzed.Result:The sFLC or its ratio was abnormally changed in 116 MM patients at the initial diagnosis,and the sFLC level in patients with stageⅢISS was significantly higher than that in patients with ISSⅠandⅡ.The positive rate of serum M protein in IFE was 87.3%.Serum free after chemotherapy.The light chainκorλlevel decreased significantly(P<0.05).The sFLCκ/λratio returned to normal in the effective group which was 70.2%.The sFLC level in the advanced patients was significantly reduced but still maintained at a high level,and the sFLCκ/λratio of 2 cases was return to normal,and patients with high sFLC may have higher tumor burden and greater invasiveness,suggesting apoor prognosis.Conclusion:sFLC detection might have important clinical application value in the early diagnosis,therapeutic evaluation and micro-tumor load detection of MM.

关 键 词：多发性骨髓瘤 血清游离轻链 免疫固定电泳 

分 类 号：R733.3[医药卫生—肿瘤]