Scudla V, Budíková M, Pika T, Minarík J, Zemanová M, Bacovský J, Heincová V
III interní klinika Lékarské fakulty UP a FN, Olomouc.
Vnitr Lek. 2006 Mar;52(3):232-40.
The study focuses on evaluation of differences in serum levels of selected biological indicators in monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM), primarily from the viewpoint of potential asset to clinical practice.
The analyse set of 96 patients consisted of 30 individuals with MGUS and 66 patients with MM examined in the context of the disease diagnosis before therapy commencement. Serum levels of the assessed parameters were examined with the help of radio-enzymatic method (thymidinkinase), radioimmunoanalysis (beta2-micro-globulin, ICTP, PINP), enzymoimmunoessay method (sIL-6R, sVCAM-1, sICAM-1, sOPG and sRANKL) and the technique of quantitative sandwich enzymatic immunoessay (sHGF, sVEGF, bFGF, syndecan-1/CD138 and sFas). Statistical examination was performed by Pearson and Fischer test, chi2-test, or nonparametric U-test pursuant to Mann-Whitney (p < 0.05).
Statistically significant differences were found between MGUS and MM in the case of serum level comparisons of sIL-6R (p = 0.02), ICTP (p = 0.001), sHGF (p = 0.001) and syndecan-1/sCD138 (p = 0.001), while no statistically significant differences were present in the case of sVCAM-1, sICAM-1, PINP, sOPG, sVEGF and sFas. During the analysis of frequency of occurrence of abnormal values in the MM and MGUS groups, significant differences were found not only in the case of standard parameters, such as beta2-microglobulin, thymidinkinase, creatinin and albumin, but also in the case of sIL-6R, ICTP, sHGF and syndecan-1, but not in comparisons of the levels of sVCAM-1, sICAM-1, PINP, sOPG, sVEGF and sFas. Attempts at examination of serum levels of sRANKL and soluble form of bFGF failed as too low values were measured.
The analysis of behaviour of the 10 parameters, mostly intimately related to biological properties of clonal plasmatic cells or to changes of microclimate of bone marrow, effectively contributed to distinction between MGUS and MM only in the case of serum levels of sIL-6R, ICTP, sHGF and syndecan-l (sCD138), i.e. indicators with demonstrable relevance for MM prognosis assessment.
本研究主要从对临床实践的潜在价值角度出发，聚焦于评估意义未明的单克隆丙种球蛋白病（MGUS）和多发性骨髓瘤（MM）患者血清中选定生物指标水平的差异。
分析的96例患者包括30例MGUS患者和66例MM患者，均在治疗开始前疾病诊断时进行检查。借助放射酶法（胸苷激酶）、放射免疫分析法（β2-微球蛋白、ICTP、PINP）、酶免疫分析法（sIL-6R、sVCAM-1、sICAM-1、sOPG和sRANKL）以及定量夹心酶免疫分析法（sHGF、sVEGF、bFGF、多配体蛋白聚糖-1/CD138和sFas）检测评估参数的血清水平。根据Pearson检验、Fischer检验、卡方检验或Mann-Whitney非参数U检验（p<0.05）进行统计学分析。
在sIL-6R（p = 0.02）、ICTP（p = 0.001）、sHGF（p = 0.001）和多配体蛋白聚糖-1/sCD138（p = 0.001）的血清水平比较中发现MGUS和MM之间存在统计学显著差异，而sVCAM-1、sICAM-1、PINP、sOPG、sVEGF和sFas则无统计学显著差异。在分析MM组和MGUS组异常值出现频率时，不仅在β2-微球蛋白、胸苷激酶、肌酐和白蛋白等标准参数方面发现显著差异，在sIL-6R、ICTP、sHGF和多配体蛋白聚糖-1方面也发现显著差异，但在sVCAM-1、sICAM-1、PINP、sOPG、sVEGF和sFas水平比较中未发现差异。由于所测sRANKL和可溶性bFGF血清水平过低，未能对其进行检测。
对10项参数行为的分析，其中大多数与克隆性浆细胞的生物学特性或骨髓微环境变化密切相关，仅在sIL-6R、ICTP、sHGF和多配体蛋白聚糖-1（sCD138）血清水平方面有效地有助于区分MGUS和MM，即这些指标对MM预后评估具有明显相关性。
