Wolf B C, Brady K, O'Murchadha M T, Neiman R S
Hematopathology Section, Mallory Institute of Pathology, Boston, Massachusetts 02118.
Am J Clin Pathol. 1990 Dec;94(6):742-6. doi: 10.1093/ajcp/94.6.742.
Bone marrow specimens from 226 patients with a variety of benign and malignant plasma cell proliferations were studied to assess the reliability of immunohistologic studies in their evaluation. The clonality of the bone marrow plasma cells was compared with results of serum and urine electrophoreses. Discordance was observed most frequently in cases in which a paraprotein was demonstrated, but no monoclonality was detected by immunoperoxidase (16 cases). Of these 16 cases, 9 had 5% or less bone marrow plasma cells. In only one case was the light chain class of the bone marrow plasma cells different from that of the paraprotein. If discordant cases with 5% or less plasma cells are eliminated, the overall concordance was 97%. The authors' findings indicate that immunohistologic studies for immunoglobulin light chains in Zenker-fixed decalcified bone marrow biopsy sections are reliable in the evaluation of patients with plasma cell proliferations when the marrow contains more than 5% plasma cells.
对226例患有各种良性和恶性浆细胞增殖性疾病的患者的骨髓标本进行了研究，以评估免疫组织学研究在其评估中的可靠性。将骨髓浆细胞的克隆性与血清和尿液电泳结果进行了比较。在证实存在副蛋白但免疫过氧化物酶检测未发现单克隆性的病例中（16例），最常观察到不一致情况。在这16例病例中，9例骨髓浆细胞占5%或更少。仅1例骨髓浆细胞的轻链类别与副蛋白不同。如果排除浆细胞占5%或更少的不一致病例，总体一致性为97%。作者的研究结果表明，当骨髓中浆细胞含量超过5%时，在Zenker固定脱钙骨髓活检切片中进行免疫球蛋白轻链的免疫组织学研究在评估浆细胞增殖性疾病患者时是可靠的。
