免疫固定电泳结合免疫球蛋白检测在多发性骨髓瘤诊断与分型中的应用评价  

Evaluation of the application of immunofixation electrophoresis combined with immunoglobulin detection in the diagnosis and classification of multiple myeloma

作　　者：翁有红 张楠 王东平 徐雨航 沈越 李洪春 WENG Youhong;ZHANG Nan;WANG Dongping;XU Yuhang;SHEN Yue(School of Medical Technology.Xuzhou Medical University,Xuzhou,Jiangsu 221002,China)

机构地区：[1]徐州医科大学医学技术学院,江苏徐州221002

出　　处：《实验与检验医学》2020年第5期839-842,867,共5页Experimental and Laboratory Medicine

基　　金：2018年江苏省大学生创新创业训练计划项目,编号201810313085H;基础医学国家级实验教学示范中心(徐州医科大学)资助项目,编号201810313085H。

摘　　要：目的探讨免疫固定电泳结合免疫球蛋白检测在多发性骨髓瘤(multiple myeloma,MM)诊断和分型中的应用。方法取徐州医科大学附属医院330例MM患者为研究对象,采用血清蛋白电泳筛选出血清M蛋白阳性患者226例,阴性104例,用免疫固定电泳对血免疫球蛋白及轻链做定性、免疫散射比浊法对血免疫球蛋白、血/尿轻链做定量分析,确定临床分型以及分析两者之间的关系。结果141例M蛋白阳性患者同时进行免疫固定电泳、血清免疫球蛋白、血/尿轻链定量检测,其检出率分别为:免疫球蛋白88.55%(116/131),血轻链95.03%(134/141),尿轻链78.72%(111/141)。而104例M蛋白阴性患者联合检测结果为:72.12%(75/104)的患者表现为血/尿轻链增高,5例血清IgG增高的MM患者中只有1例免疫固定电泳IgG阳性。结论免疫固定电泳结合免疫球蛋白定量检测有助于提高MM检出率,对MM进行分型,统计不同地区的分型可为临床工作者的诊断和预后判断提供重要依据,并制定个体化治疗方案。Objective To investigate the application of immunofixation electrophoresis combined with immunoglobulin detection in the diagnosis and classification of multiple myeloma(MM).Methods a total of 330 patients with MM in Xuzhou Medical University Hospital were enrolled in this study,226 patients with serum M protein positive were screened by serum protein electrophoresis,and 104 were negative.The immunoglobulin and light chain were qualitatively and immunostained by immunofixation electrophoresis.The turbidimetric method quantitatively analyzes blood immunoglobulins and blood/urine light chins,determines clinical classification and analyzes the relationship between the two.Results 141 patients with positive M protein were simultaneously immunoelectrolyzed,serum immunoglobulin and blood/urine light chins.The detection rates were 88.55%(116/131)for immunoglobulin and 95.03%for light chain(134/141),urinary light chain 78.72%(111/141).The combined detection results of 104 patients with M protein negative were:72.12%(75/104)patients showed elevated blood/urine light chins,and 5 patients with MM with elevated serum lgG had only one immunofixation lgG positive in china.Conclusion immunofixation electrophoresis combined with immunoglobulin quantitative detection can improve the detection rate of MM,classify MM,and statistical classification of different regions can provide an important basis for clinicians to diagnose and prognosis,and develop individualized treatment.

关 键 词：多发性骨髓瘤 免疫固定电泳 免疫散射比浊法 血清轻链 尿液轻链 

分 类 号：R446.61[医药卫生—诊断学] R551.3[医药卫生—临床医学]