免疫球蛋白定量检测及蛋白电泳在少见型多发性骨髓瘤诊断中的应用

摘要

Objective To explore the application and diagnostic value of immunoglobulin quantitative detection ,serum protein e‐lectrophoresis and immunofixation electrophoresis in diagnosing rare types of multiple myeloma(MM ) .Methods Thirty‐one pa‐tients with rare types of MM in our hospital during 2014-2015 were collected ,including 22 cases of λlight chain type ,7 cases ofκlight chain type and 2 cases of λlight chain and IgDλbiclonal type .The fasting venous blood 3 mL was collected and separated for obtaining serum .The immunoglobulin quantitative detection ,serum protein electrophoresis and immunofixation were performed and their diagnostic value in rare types of MM was evaluated .Results The positive rate of M protein detected by serum protein electro‐phoresis was 29 .03% ,the M protein content had statistical difference between the Durie‐Salmon clinical stage Ⅱ and Ⅲ (P<0 .05);IgG and IgM had statistical difference between the rare types of MM and IgG κ(P< 0 .05);IgA and IgM had statistical difference between MM and IgAκtype(P<0 .05) .Conclusion The immunoglobulin quantitative detection and immunofixation can serve as the screening method for M protein in rare types of MM and serum electrophoresis can play the guidance value for the clini‐cal staging and curative effect .%目的：探讨免疫球蛋白定量检测、血清蛋白电泳及免疫固定电泳在少见型多发性骨髓瘤（M M ）诊断中的应用及诊断价值。方法收集2014～2015年该院31例少见型M M瘤患者，其中λ轻链型22例，κ轻链型7例，λ轻链及IgD λ双克隆型2例。空腹采集静脉血3 mL ，分离血清，检测免疫球蛋白定量、血清蛋白电泳及免疫固定电泳，评价其在少见型M M 中的诊断价值。结果血清蛋白电泳检测到M蛋白的阳性率29．03％，Durie‐Salmon分期临床Ⅱ期与Ⅲ期M 蛋白水平比较，差异具有统计学意义（P＜0．05）；少见型MM与IgG κ型的IgG及IgM比较，差异具有统计学意义（P＜0．05）；与IgA κ型的IgA及IgM比较，差异具有统计学意义（P＜0．05）。结论免疫球蛋白定量和免疫固定电泳可作为少见型MM患者M蛋白的筛查方法，血清蛋白电泳则可对MM患者的临床分期和疗效起到指导价值。