Maisnar V, Tousková M, Tichý M, Krejsek J, Chrobák L, Voglová J, Malý J
2nd Department of Medicine-Department of Clinical Hematology, Charles University Teaching Hospital, 50005 Hradec Králové, Czech Republic.
Neoplasma. 2006;53(1):26-9.
Report is summary of the results of study designed to ascertain the significance of soluble CD138 (sCD138) assessment in patients with different monoclonal gammopathies. Previous studies have shown that sCD138 is shed from the surface of myeloma cells into serum and that this marker is a new independent prognostic parameter in multiple myeloma. In presented study was evaluated serum sCD138 level in 14 patients with monoclonal gammopathy of undetermined significance (MGUS) and in 17 patients with multiple myeloma (MM), all MM patients were treated by high-dose chemotherapy regimen with subsequent autologous transplantation of peripheral blood stem cells. To determine the sCD138 level we used a rapid and simple ELISA procedure. The mean serum sCD138 level of patients with MGUS was 32 ng/ml (range: 5-128). Soluble CD138 levels were elevated in the sera of 10 out of 17 (59%) multiple myeloma patients, the mean baseline sCD138 concentration was 1542 ng/ml (range: 10-17300). In spite of small number of patients the difference between MGUS and MM group was highly statistically significant (p<0.001). Multiple myeloma patients with high level of sCD138 at diagnosis (cut-off value: 500 ng/ml) had worse prognosis despite of good response to chemotherapy in some of them (p=0.029). It seems that determination of sCD138 can be recommended as a helpful and reliable marker for differential diagnosis as well as prognosis of monoclonal gammopathies.
本报告总结了一项旨在确定可溶性CD138（sCD138）评估在不同单克隆丙种球蛋白病患者中的意义的研究结果。既往研究表明，sCD138从骨髓瘤细胞表面脱落进入血清，且该标志物是多发性骨髓瘤新的独立预后参数。在本研究中，对14例意义未明的单克隆丙种球蛋白病（MGUS）患者和17例多发性骨髓瘤（MM）患者的血清sCD138水平进行了评估，所有MM患者均接受了大剂量化疗方案及随后的外周血干细胞自体移植。为测定sCD138水平，我们采用了一种快速简便的ELISA方法。MGUS患者的血清sCD138平均水平为32 ng/ml（范围：5 - 128）。17例MM患者中有10例（59%）血清sCD138水平升高，基线sCD138平均浓度为1542 ng/ml（范围：10 - 17300）。尽管患者数量较少，但MGUS组和MM组之间的差异具有高度统计学意义（p<0.001）。诊断时sCD138水平高的MM患者（临界值：500 ng/ml）预后较差，尽管其中一些患者对化疗反应良好（p = 0.029）。似乎sCD138的测定可作为单克隆丙种球蛋白病鉴别诊断及预后的有用且可靠标志物被推荐。
