Scudla V, Budíková M, Pika T, Bacovský J, Minarík J, Heinzová V, Langová K
3. interni klinika LF UP a FN Olomouc, Olomouc.
Cas Lek Cesk. 2009;148(7):315-22.
The aim of the study was the evaluation of serum levels of 12 selected biomarkers in monoclonal gammopathy of undetermined significance (MGUS) and in initial, asyptomatic phase of multiple myeloma, especially from the view of potential differentiation of these conditions in clinical practice.
Analyzed group of 268 individuals consisted of 89 individuals with MGUS and 179 patients with MM examined in time of diagnosis before treatment initiation. For evaluation of serum levels were used following methods: radioenzymatic method (thymidinekinase), enzymatic immunoassay (beta2-M, IL-6R, ICAM-1, VCAM-1, ICTP, PINP and OPG) and quantitative sandwich enzymatic immunoassay (HGF, VEGF, syndecan-1/CD138 and Fas). Pearson's chi2-test and test according to Mann-Whitney were used for statistical evaluation (p < 0.05). Wide statistic differences in serum levels of analyzed markers in MGUS vs. MM were detected in case of beta2-M, TK, ICTP, OPG, HGF and syndecan-1 (p < 0.0001), lower differences in case of VCAM-1, PINP and VEGF (p = 0.003, 0.001 and 0.04), and without difference in case of Fas. Except for thymidinekinase (p = 0.014) and syndecan-1 (p = 0.001) was not detected statistically important contrast of measured values in MGUS individuals and in patients with initial, asymptomatic phase of MM (stage 1), but these markers cannot be used in clinical practice due to significant overlap of serum values. Continuous downgrade of serum values of VEGF due to degree of MM progression (stages 1-3 according to Durie-Salmon) was unexpected.
Although the significant differences in 9 of 12 evaluated serum levels of selected biomarkers in groups of MGUS and MM were seen, the results revealed that these markers are unprofitable to bring discriminatory potential capable of being used to distinguish between MGUS and initial, asymptomatic phase of MM.
本研究旨在评估意义未明的单克隆丙种球蛋白病（MGUS）以及多发性骨髓瘤初始无症状期患者血清中12种选定生物标志物的水平，特别是从临床实践中区分这些病症的潜在角度进行评估。
分析的268例个体包括89例MGUS患者和179例在治疗开始前诊断时接受检查的MM患者。采用以下方法评估血清水平：放射酶法（胸苷激酶）、酶免疫测定法（β2 - M、IL - 6R、ICAM - 1、VCAM - 1、ICTP、PINP和OPG）以及定量夹心酶免疫测定法（HGF、VEGF、Syndecan - 1/CD138和Fas）。采用Pearson卡方检验和曼 - 惠特尼检验进行统计学评估（p < 0.05）。在MGUS与MM患者中，β2 - M、TK、ICTP、OPG、HGF和Syndecan - 1的血清水平存在显著统计学差异（p < 0.0001），VCAM - 1、PINP和VEGF的差异较小（p = 0.003、0.001和0.04），Fas则无差异。除胸苷激酶（p = 0.014）和Syndecan - 1（p = 0.001）外，未检测到MGUS个体与MM初始无症状期患者（1期）测量值的统计学显著差异，但由于血清值存在显著重叠，这些标志物无法用于临床实践。VEGF血清值因MM进展程度（根据Durie - Salmon分期为1 - 3期）持续下降，这一结果出乎意料。
尽管在MGUS组和MM组中，12种评估的选定生物标志物血清水平中有9种存在显著差异，但结果表明这些标志物在区分MGUS和MM初始无症状期方面缺乏可用于鉴别诊断的潜力。
