目的：探讨多发性骨髓瘤单克隆免疫球蛋白（M蛋白）的临床诊断价值。方法采用免疫固定电泳（IFE）、血清蛋白电泳（SPE）及免疫球蛋白定量（Ig）技术检测105例多发性骨髓瘤患者的血清和尿液，其中10例MM患者进行自体骨髓移植，对其血清M蛋白的表达进行跟踪检测。结果105例多发性骨髓瘤患者血清免疫固定电泳M蛋白105例阳性，阳性率为100．0％；尿本周氏蛋白阳性76例，阳性率为72．4％（76/105）。25例血清M蛋白为轻链型患者尿本周蛋白阳性率为92．0％（23/25）；血清蛋白电泳78例出现M带，检出率为74．3％（78/105）；免疫球蛋白定量68例显著升高，阳性率为64．8％（68/105）。结论免疫固定电泳检测M蛋白对诊断MM具有高度的敏感性和特异性，是M蛋白定性和分型的重要指标；血清蛋白电泳和免疫球蛋白定量检测M蛋白可早期筛查MM，减少误诊或漏诊；三项指标联合检测M蛋白对MM的诊断、病情监测、疗效评估及预后判断提供重要依据。%Objective To evaluate the value of laboratory tests for monoclonal immunoglobulin (M protein) in clinical diagnosis of multiple myeloma (MM). Methods Immunofixation electrophoresis (IFE), serum protein elec-trophoresis (SPE) and immunoglobulin quantification (IQ) were used to evaluate the M protein in the serum and urine samples from 105 MM patients, including 10 MM patients undergoing autologous bone marrow transplantation. The expression of serum M protein was followed up. Results Of 105 MM patients, IFE detected serum M protein in 100%(105/105), and urine Bence-Jones protein in 72.4%(76/105). Of 25 MM patients with serum light-chain M pro-tein, 92.0% (23/25) tested positive for urine Bence-Jones protein. SPE showed M band in 78 cases, with a detection rate of 74.3%(78/105). Immunoglobulin quantification indicated significantly higher level of M protein in 68 MM pa-tients, with the positive rate being 64.8%(68/105). Conclusion IFE test for M protein is highly sensitive and specif-ic for the diagnosis of MM, and is important for characterization and classification of M proteins; SPE and IQ tests for M protein may be used for early screening of MM, and may reduce misdiagnosis or negligence of MM. When used in combination, the three tests for M protein may offer important evidence for the diagnosis, monitoring, outcome evalua-tion and prognosis of MM.
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