单克隆丙种球蛋白在临床就诊患者中的特点与分布规律的单中心研究  

Characteristics and distribution of monoclonal gammopathy in clinical patients:a single-center study

作　　者：朱丽娜 邵文琦 朱晶 沈若坚 吴群 潘柏申 王蓓丽 郭玮 Zhu Lina;Shao Wenqi;Zhu Jing;Shen Ruojian;Wu Qun;Pan Baishen;Wang Beili;Guo Wei(Department of Laboratory Medicine,Shanghai Geriatric Medical Center,Shanghai 201104,China;Department of Laboratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]上海市老年医学中心检验科,上海201104 [2]复旦大学附属中山医院检验科,上海200032

出　　处：《中华检验医学杂志》2024年第1期72-77,共6页Chinese Journal of Laboratory Medicine

基　　金：复旦大学附属中山医院临床研究专项(2020ZSLC54);复旦大学附属中山医院科技创新基金(2021ZSCX12);上海市临床重点专科建设项目(shslczdzk03302)。

摘　　要：目的探讨单克隆丙种球蛋白(M蛋白)在临床就诊患者中的特点与分布规律。方法选择2012年1月至2021年12月在复旦大学附属中山医院就诊并进行毛细管区带电泳的936171例患者(男508449例,女427722例),筛选出异常条带的14945例患者作为研究对象,男10173例,女4772例,年龄21~102(65±13)岁。按年龄分为21~30岁(168例)、31~40岁(405例)、41~50岁(1326例)、51~60岁(3068例)、61~70岁(4985例)、71~80岁(3288例)、81~90岁(1519例)、≥91岁(186例)共8组。收集14945例检出异常条带患者的诊断结果,按有无肿瘤分为肿瘤组(5196例)和非肿瘤性组(9749例)。回顾性分析不同性别、年龄和疾病组中异常条带分布情况。14945例患者中,4988例进行了免疫固定电泳试验,排除336例阴性和412例双克隆条带反应,以具有单克隆免疫球蛋白(M蛋白)反应的4240例患者为研究对象,男2794例,女1446例,年龄21~102(67±12)岁。按年龄分为21~30岁(18例)、31~40岁(91例)、41~50岁(364例)、51~60岁(862例)、61~70岁(1455例)、71~80岁(904例)、81~90岁(486例)、≥91岁(60例)共8组,收集患者的诊断结果与免疫球蛋白(Ig)分型(IgA-κ、IgA-λ、IgG-κ、IgG-λ、IgM-κ、IgM-λ、κ、λ)结果,回顾性分析M蛋白在不同性别、年龄和疾病组的分布情况。结果在936171例患者中,电泳图谱表现出异常条带者为14945例,检出率为1.60%;其中,男性和女性异常条带检出率分别为2.00%(10173/508449)和1.12%(4772/427722),差异有统计学意义(P<0.01)。不同年龄组间的异常条带检出率差异有统计学意义(P<0.01);其中,≥91岁组异常条带检出率最高为5.98%,男女检出比1.67∶1。14945例异常条带中,51~60、61~70、71~80岁患者分别占20.53%(3068例)、33.36%(4985例)和22.00%(3288例),各年龄组间差异均有统计学意义(χ^(2)=115.82,P<0.01)。肿瘤组中检出异常条带前3位者为浆细胞瘤1123例,淋巴瘤289例,白血病49例,浆细胞瘤电泳图谱异常条带检出率为89.92Objective To investigate the characteristics and distribution of monoclonal gammopathy in clinical patients.Methods A total of 936171 patients(508449 males and 427722 females)who received capillary zone electrophoresis in Zhongshan Hospital Affiliated to Fudan University from January 2012 to December 2021 were selected,from which 14945 patients with abnormal bands were screened as the study subjects,including 10173 males and 4772 females and the age 21-102(65±13)years old.According to the age,patients were divided into 8 groups:21-30 years old(168 cases),31-40 years old(405 cases),41-50 years old(1326 cases),51-60 years old(3068 cases),61-70 years old(4985 cases),71-80 years old(3288 cases),81-90 years old(1519 cases),and≥91 years old(186 cases).The diagnostic results of the 14945 patients with abnormal bands were collected and were divided into tumor group(5196 cases)and non-tumor disease group(9749 cases)according to the presence of tumor.The distribution of abnormal bands in different gender,age,and disease groups were retrospectively analyzed.Among the 14945 patients,4988 cases underwent immunofixation electrophoresis,excluding 336 negative cases and 412 cases of double clonal bands reaction,and 4240 patients with monoclonal immunoglobulin(M protein)reaction were selected as the study subjects,including 2794 males and 1446 females aged 21-102(67±12)years old.They were divided into 8 groups according to the age:21-30 years old(18 cases),31-40 years old(91 cases),41-50 years old(364 cases),51-60 years old(862 cases),61-70 years old(1455 cases),71-80 years old(904 cases),81-90 years old(486 cases),and≥91 years old(60 cases).The diagnostic results and immunoglobin subtypes(IgA-κ,IgA-λ,IgG-κ,IgG-λ,IgM-κ,IgM-λ,κ,λ)of patients were collected,and the distribution of monoclonal gammopathy in different gender,age and disease groups were retrospectively analyzed.Results Among 936171 patients,14945 cases showed abnormal bands in electropherograms with a detection rate of 1.60%;the detection rates of abnorma

关 键 词：电泳 毛细管 免疫电泳 浆细胞瘤 单克隆丙种球蛋白 单克隆条带 

分 类 号：R446.6[医药卫生—诊断学]