血清游离轻链在B细胞非霍奇金淋巴瘤中的表达水平及诊断价值  

The Expression Level and Diagnostic Value of Serum Free Light Chain in B-Cell Non-Hodgkin Lymphoma

作　　者：王琰[1] 王慧[1] 张建富[1] 李建勇[1] 张宁涵 王蓉[1] WANG Yan;WANG Hui;ZHANG Jian-Fu;LI Jian-Yong;ZHANG Ning-Han;WANG Rong(Department of Hematology,The First Affiliated Hospital of Nanjing Medical University,Jiangsu Provincial People Hospital,Nanjing 210029,Jiangsu Province,China)

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

出　　处：《中国实验血液学杂志》2023年第6期1701-1705,共5页Journal of Experimental Hematology

摘　　要：目的:探讨血清游离轻链(sFLC)在B细胞非霍奇金淋巴瘤(B-NHL)中的表达水平及诊断价值。方法:回顾性分析2014年1月至2021年12月江苏省人民医院394例初治B-NHL患者的血清游离轻链结果,比较不同亚型B-NHL中sFLC的分泌水平。评估sFLC分泌水平在华氏巨球蛋白(WM)诊断中的价值。结果:sFLC增高比例、sFLC(κ/λ)异常比例及sFLC(κ+λ)分泌水平在不同B-NHL亚型中均存在差异性,WM的sFLC增高者比例(82.6%)与sFLC(κ/λ)比值异常患者比例(87.0%)最高,而sFLC增高者比例最低的为FL(18.0%)与DLBCL(12.8%)(P<0.05)。sFLC的表达水平可以辅助诊断WM(AUC=0.874,P<0.001,0.779-0.970)。同时,较高的sFLC水平及sFLC克隆模式可以预测淋巴瘤骨髓浸润的可能。结论:B-NHL患者血清中存在游离轻链,轻链的增高水平和增高类型与淋巴瘤类别存在相关性,且骨髓浸润患者有着更高的sFLC(κ+λ)表达水平。Objective:To investigate the expression level and the diagnostic value of serum free light chain in B-cell non-Hodgkin's lymphoma(B-NHL).Methods:We retrospectively analyzed the results of serum free light chain(sFLC)of394newly treated B-NHL patients in our hospital from January2014to December2021and compared the secretion levels of sFLC among different subtypes of B-NHL.The value of sFLC secretion levels in the diagnosis of WM was evaluated using ROC.Results:Increased proportion of sFLC,abnormal ratio of sFLC(κ/λ)and the secretion levels of sFLC(κ + λ)were different in different B-NHL subtypes,Waldenstrom's macroglobulinemia(WM)had the highest proportion of elevated sFLC(82.68%)and abnormal sFLC(κ/λ)(87.0%),the proportion of FL(18.0%)and DLBCL patients(12.8%)with elevated sFLC was lower(P<0.05).The expression levels of sFLC can helpful in the diagnosis of WM(AUC= 0.874,P<0.001,95% CI:0.779-0.970).At the same time,higher sFLC levels and sFLC cloning patterns predicted the possibility of bone marrow infiltration of lymphoma.Conclusion:The serum free light chains is common in patients with B-NHL.The elevated level and type of free light chain are associated with the type of lymphoma,and the patients with bone marrow infiltration have higher sFLC(κ + λ)expression level.

关 键 词：B细胞非霍奇金淋巴瘤 血清游离轻链 骨髓浸润 

分 类 号：R733.1[医药卫生—肿瘤]