多发性骨髓瘤本周氏蛋白检测及其临床意义
摘要
目的探讨尿本周氏蛋白电泳、血清本周氏蛋白电泳、血清免疫固定电泳、血清和尿液轻链定量及其比值在多发性骨髓瘤(MM)患者中的临床意义。方法 33例尿本周氏蛋白电泳阳性的多发性骨髓瘤患者血、尿标本分别用血清蛋白电泳、血清本周氏蛋白电泳、血清免疫固定电泳进行检测并分析四种电泳结果,同时利用散射免疫比浊法测定患者血清免疫球蛋白浓度及尿液中蛋白及κ、λ轻链的浓度,并计算κ/λ比值。通过与100例非MM病人血、尿检测结果对照,结合电泳结果评价本周氏蛋白检测在MM临床诊断中的意义。结果血清本周氏蛋白电泳结合血清免疫固定电泳可进一步提高MM筛查的阳性率及分型的准确性。尿液和血液中κ、λ的浓度,κ/λ值与对照组相比较,具有显著的统计学差异(P<0.01)。结论尿液κ/λ的比值对尿蛋白阳性病人的本周氏蛋白检出有一定的意义,在用于MM的筛查方面值得进一步探讨。
引文
[1][美]威廉姆·J·威廉姆斯主编,傅剑峰主译.威廉姆斯血液学[M].北京:中国人民出版社,1998:1342-1345.
[2]Barlogie B,Shaughnessy J,Tricot G,Jacobson J,et al.Treatment of multiplemyeloma[J].Blood,2004,103(1):20-32.
[3]吕世静.临床免疫学检验[M].北京:中国医药科学出版社,2004,386-389.
[4]杨志才,高玉洁,张春明,钱铸山.多发性骨髓瘤血清蛋白电泳与免疫学分型[J].国外医学(临床生物化学与检验学分册),2005,26(7):413-414,417.
[5]Waldmann TA,Strober W,Mogielnicki RP,et al.The renalhandling of low molecular weight proteins.II.Disorders of serumprotein catabolism in patients with tubular proteinuria,the nephroticsyndrome or uremia[J].J Clin Invest,1972,51:2162-2174.
[6]Tate JR,Mollee P,Dimeski G,et al.Analytical performance of serum free light-chain assay during monitoring of patients with monoclonal light-chain diseases[J].Clin Chim Acta,2007,376:30-36.
[7]Abe M,Goto T,Kosaka M,et al.Differences in kappa to lambda(κ:λ)ratios of serum and urinary free light chains[J].Clin Experimental Immunol,1998,111:457-462.
[8]Pratt G.The evolving use of serum free light chain assays in haematology[J].Briti J Haematol,2004,141:413-422.
[9]So YK,Jin TS,Hee JL,et al.Clinical usefulness of free light chainconcentration as a tumor marker in multiple myeloma[J].Ann Hematol,2005,84:588-593.
[10]Katzmann JA.Serum free light chain specificity and sensitivity:A Reality Check[J].Clin Chem,2006,9:52-53.
[11]叶任高,陆再英.内科学[M].北京:人民卫生出版社,2006:631-635.
[12]白洁,孙玲,丛玉隆.血清免疫固定电泳在骨髓瘤肾病患者诊断中的意义[J].中华医学检验杂志,2003,26(9):543-545.
[13]姚红,吴亚楠.免疫固定电泳对多发性骨髓瘤的临床应用价值[J].实用癌症杂志,2014,30(1):91-92.
[14]卢娉霞,陈莺,张敬喜.免疫固定电泳在多发性骨髓瘤免疫分型中的应用[J].实验与检验医学杂志,2009,27(3):267-268.
[15]Jon R,Jan O.The usefulness of quantifying kappa and lambda light chain[J].Chinenes Chemical Letters.1996,32(5):899.
[16]翟玉华,张惠玲,宿莉,等.血清免疫球蛋白轻链含量检测对M蛋白血症的论断意义[J].临床血液学杂志,2000,13(4):177-178.
[17]王继贵.用血清游离轻链分析法检测单克隆γ-病[J].实验与检验医学杂志,2014,32(3):233-236.
[18]颜绵生,喻雄文,高玲.免疫固定电泳法的应用-检测本-周氏蛋白[J].中华检验医学杂志,2001,24(5):269-271.
[19]裴姝文,刘杰.多发骨髓瘤患者本周氏蛋白与肾损伤相关性分析[J].现代肿瘤医学杂志,2016,24(13):2147-2149.
[2]Barlogie B,Shaughnessy J,Tricot G,Jacobson J,et al.Treatment of multiplemyeloma[J].Blood,2004,103(1):20-32.
[3]吕世静.临床免疫学检验[M].北京:中国医药科学出版社,2004,386-389.
[4]杨志才,高玉洁,张春明,钱铸山.多发性骨髓瘤血清蛋白电泳与免疫学分型[J].国外医学(临床生物化学与检验学分册),2005,26(7):413-414,417.
[5]Waldmann TA,Strober W,Mogielnicki RP,et al.The renalhandling of low molecular weight proteins.II.Disorders of serumprotein catabolism in patients with tubular proteinuria,the nephroticsyndrome or uremia[J].J Clin Invest,1972,51:2162-2174.
[6]Tate JR,Mollee P,Dimeski G,et al.Analytical performance of serum free light-chain assay during monitoring of patients with monoclonal light-chain diseases[J].Clin Chim Acta,2007,376:30-36.
[7]Abe M,Goto T,Kosaka M,et al.Differences in kappa to lambda(κ:λ)ratios of serum and urinary free light chains[J].Clin Experimental Immunol,1998,111:457-462.
[8]Pratt G.The evolving use of serum free light chain assays in haematology[J].Briti J Haematol,2004,141:413-422.
[9]So YK,Jin TS,Hee JL,et al.Clinical usefulness of free light chainconcentration as a tumor marker in multiple myeloma[J].Ann Hematol,2005,84:588-593.
[10]Katzmann JA.Serum free light chain specificity and sensitivity:A Reality Check[J].Clin Chem,2006,9:52-53.
[11]叶任高,陆再英.内科学[M].北京:人民卫生出版社,2006:631-635.
[12]白洁,孙玲,丛玉隆.血清免疫固定电泳在骨髓瘤肾病患者诊断中的意义[J].中华医学检验杂志,2003,26(9):543-545.
[13]姚红,吴亚楠.免疫固定电泳对多发性骨髓瘤的临床应用价值[J].实用癌症杂志,2014,30(1):91-92.
[14]卢娉霞,陈莺,张敬喜.免疫固定电泳在多发性骨髓瘤免疫分型中的应用[J].实验与检验医学杂志,2009,27(3):267-268.
[15]Jon R,Jan O.The usefulness of quantifying kappa and lambda light chain[J].Chinenes Chemical Letters.1996,32(5):899.
[16]翟玉华,张惠玲,宿莉,等.血清免疫球蛋白轻链含量检测对M蛋白血症的论断意义[J].临床血液学杂志,2000,13(4):177-178.
[17]王继贵.用血清游离轻链分析法检测单克隆γ-病[J].实验与检验医学杂志,2014,32(3):233-236.
[18]颜绵生,喻雄文,高玲.免疫固定电泳法的应用-检测本-周氏蛋白[J].中华检验医学杂志,2001,24(5):269-271.
[19]裴姝文,刘杰.多发骨髓瘤患者本周氏蛋白与肾损伤相关性分析[J].现代肿瘤医学杂志,2016,24(13):2147-2149.