果糖胺、免疫球蛋白及轻链定量联合检测在多发性骨髓瘤诊断和分型中的应用

发布时间：2018-11-05 20:29

【摘要】：目的探讨果糖胺(FMN)、免疫球蛋白(Ig)及轻链(LC)联合检测在多发性骨髓瘤(MM)诊断和分型中的价值。方法选择169例MM患者为研究对象,同期健康体检人群50例作为对照组,初诊时进行FMN、Ig及LC检测。FMN采用硝基四氮唑蓝比色法测定,Ig和LC采用免疫散射比浊法测定。169例MM包括IgG型88例、IgA型53例、LC型28例,所有患者均排除糖尿病。结果 Ig、LC定量测定结果显示,在各型MM患者血清中出现相应Ig及LC的变化,无论是κ型还是λ型M蛋白,κ/λ比值均差异有统计学意义(P0.05)。53例IgA型MM患者FMN平均水平明显高于IgG型、LC型和对照组(P0.05),IgG型、LC型组FMN平均水平与对照组比较差异无统计学意义(P0.05)。FMN、IgA、κ/λ单独及3项联合检测对诊断IgA型MM的敏感度分别为96.2%、81.1%、92.5%、98.1%,特异度分别为78.0%、100%、94.0%、76.0%。IgA和κ/λ联合检测的敏感度和特异度分别为98.1和94.0%,与3项联合检测敏感度相当,但特异度比3项联合检测明显提高。结论 FMN在IgA型MM中存在异常增高的现象,可作为IgA型MM的初筛指标,初筛阳性联合Ig及LC进行定量检测,可明显提高IgA型MM的检出率。
[Abstract]:Objective to investigate the value of fructosamine (FMN), immunoglobulin (Ig) and light chain (LC) in the diagnosis and typing of multiple myeloma. Methods FMN,Ig and LC were detected in 169 patients with MM and 50 healthy controls at the same time. FMN was determined by nitrotetrazolyl blue colorimetry. Ig and LC were determined by immunoturbidimetric method. 169 cases of MM included 88 cases of IgG type, 53 cases of IgA type and 28 cases of LC type. All patients were excluded from diabetes mellitus. Results the results of Ig,LC quantitative analysis showed that the corresponding changes of Ig and LC appeared in the serum of patients with MM, whether 魏 type or 位 type M protein. The average level of FMN in 53 patients with IgA type MM was significantly higher than that in IgG type, LC type and control group (P0.05), IgG, P 0.05). There was no significant difference in the average level of FMN between the LC type group and the control group (P0.05). The sensitivity of FMN,IgA, 魏 / 位 to the diagnosis of IgA type MM was 96.2% and 81.1%, respectively. The sensitivity and specificity of the combined detection were 98.1 and 94.0, and the sensitivity and specificity of IgA and 魏 / 位 were 98.1 and 94.0, respectively. But the specificity was significantly higher than that of three combined tests. Conclusion there is an abnormal increase of FMN in IgA type MM, which can be used as a primary screening index of IgA type MM. The positive primary screening combined with Ig and LC can significantly increase the detection rate of IgA MM.
【作者单位】：河北省沧州中西医结合医院实验诊断科;沧州市人民医院护理部;
【基金】：河北省医学科学研究重点课题计划(编号:20150540)
【分类号】：R733.3;R730.43

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