Handy B C
Department of Laboratory Medicine, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
Arch Pathol Lab Med. 2001 Apr;125(4):555-7. doi: 10.5858/2001-125-0555-UMMAAB.
Bence Jones proteinuria, a common clinical manifestation of multiple myeloma, can also be seen in patients with other B-cell-derived neoplasms. Measurement of pretreatment levels is a useful adjunct in the diagnosis and staging of multiple myeloma, whereas serial levels reflect response to therapy. Serum concentrations of beta2-microglobulin, a small-molecular-weight protein associated with the major histocompatibility complex class I antigens, are often elevated in hematopoietic neoplasms and are also commonly measured at baseline, before treatment, and serially throughout therapy in patients with multiple myeloma and other lymphoproliferative disorders as a marker of tumor burden. Urinary concentrations, however, are considered an indicator of renal tubular function. High urinary levels are found in tubular proteinuria, a frequent sequela of long-standing multiple myeloma. A case is described in which a high urinary concentration of beta2-microglobulin interfered with Bence Jones protein quantification by electrophoresis studies.
本周蛋白蛋白尿是多发性骨髓瘤的常见临床表现，也可见于其他B细胞源性肿瘤患者。治疗前水平的测定是多发性骨髓瘤诊断和分期的有用辅助手段，而连续测定水平则反映对治疗的反应。β2-微球蛋白是一种与主要组织相容性复合体I类抗原相关的小分子蛋白，其血清浓度在造血系统肿瘤中常升高，在多发性骨髓瘤和其他淋巴增殖性疾病患者中，也常在基线、治疗前以及整个治疗过程中进行连续测定，作为肿瘤负荷的标志物。然而，尿中浓度被认为是肾小管功能的指标。在肾小管蛋白尿（长期多发性骨髓瘤的常见后遗症）中可发现高尿水平。本文描述了一例尿中β2-微球蛋白高浓度干扰电泳研究对本周蛋白定量的病例。
