非分泌型多发性骨髓瘤血清游离轻链的检测及其临床意义
[Detection of serum free light chain and its clinical significance in nonsecretory multiple myeloma].
作者信息
Chen Hai-Fei, Hou Jian, Yuan Zhen-Gang, Wang Dong-Xing, Fu Wei-Jun, Chen Yu-Bao
机构信息
Department of Hematology, Changzheng Hospital, Shanghai 200003, China.
出版信息
Zhonghua Xue Ye Xue Za Zhi. 2008 Feb;29(2):113-6.
OBJECTIVE
To explore the clinical significance of serum free light chain (sFLC) levels in nonsecretory multiple myeloma (NSMM).
METHODS
Nine NSMM patients were hospitalized in our department from Feb 2002 to Sep 2006 and no M-components was found in their serum and urine by immunofixation electrophoresis (IFE). sFLC was assayed by immuno-nephelometry. The clonality of sFLC was estimated by serum kappa:lambda sFLC ratio. Meanwhile, serum immunoglobulin, total kappa and lambda light chain level were also determined in these patients.
RESULTS
Increased serum concentrations of either kappa or lambda sFLC (and abnormal kappa/lambda ratios) were detected in 6 of 9 patients with NSMM although their serum immunoglobulin levels were not elevated and total kappa:lambda light chain ratios (1.32 - 2.20) were in the reference range. All the 9 patients had clonal IgH gene rearrangements.
CONCLUSION
Quantification of sFLC by immuno-nephelometry is more sensitive than that of serum total light chain measurement and is helpful in estimating the clonality of the light chain in patients with NSMM.
目的
探讨血清游离轻链（sFLC）水平在非分泌型多发性骨髓瘤（NSMM）中的临床意义。
方法
2002年2月至2006年9月，9例NSMM患者入住我科，免疫固定电泳（IFE）检测其血清和尿液中未发现M蛋白成分。采用免疫比浊法检测sFLC。通过血清κ：λ sFLC比值评估sFLC的克隆性。同时，测定这些患者的血清免疫球蛋白、总κ和λ轻链水平。
结果
9例NSMM患者中有6例检测到血清κ或λ sFLC浓度升高（以及κ/λ比值异常），尽管其血清免疫球蛋白水平未升高，且总κ：λ轻链比值（1.32 - 2.20）在参考范围内。所有9例患者均有克隆性IgH基因重排。
结论
免疫比浊法定量检测sFLC比血清总轻链检测更敏感，有助于评估NSMM患者轻链的克隆性。
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