[多发性骨髓瘤三种诊断标准的比较分析]

[A comparative analysis of three diagnostic criteria for multiple myeloma].

作者信息

Lu Jin, Huang Xiao-jun

机构信息

Peking University People's Hospital, Institute of Hematology, Beijing, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2012 Feb;51(2):114-6.

PMID:22490811

Abstract

OBJECTIVE

To compare the sensitivity among three diagnostic criteria for multiple myeloma.

METHODS

A total of 220 patients with multiple myeloma were studied retrospectively to compare the sensitivity, as well as their clinical manifestations, cell morphology in bone marrow and immunophenotype.

RESULTS

(1) The sensitivity of domestic diagnostic criterion in 1975 was 79.1% (174/220) and there were some drawbacks in type identify. The sensitivity of WHO diagnostic criterion in 2001 was 97.3% (214/220) and the sensitivity of domestic diagnostic criteria in 2011 was 100%. (2) Immunoglobulin level in 12.7% (28/220) patients was < 30 g/L, plasma cells count in bone marrow in 13.6% (30/220) was < 10%; 2.7% (6/220) patients had not met the standard in immunity globulin and bone marrow plasma cells count. (3) The immunophenotype was CD(38) positive (100%), restricted light chain (kappa/lambda) and CD(19)100%, CD(138) (98.2%, 216/220) negative.

CONCLUSIONS

Among the three diagnostic criteria, the highest was 2011 domestic diagnostic criteria. Comprehensive analysis include clinical manifestations, cell morphology, immunophenotype will contribute to the diagnosis for multiple myeloma.

摘要

目的

比较三种多发性骨髓瘤诊断标准的敏感性。

方法

回顾性研究220例多发性骨髓瘤患者，比较其敏感性、临床表现、骨髓细胞形态及免疫表型。

结果

（1）1975年国内诊断标准的敏感性为79.1%（174/220），在类型识别方面存在一些缺陷。2001年世界卫生组织（WHO）诊断标准的敏感性为97.3%（214/220），2011年国内诊断标准的敏感性为100%。（2）12.7%（28/220）患者的免疫球蛋白水平<30 g/L，13.6%（30/220）患者骨髓浆细胞计数<10%；2.7%（6/220）患者的免疫球蛋白和骨髓浆细胞计数未达标准。（3）免疫表型为CD(38)阳性（100%），轻链受限（kappa/lambda）且CD(19)100%，CD(138)阴性（98.2%，216/220）。