Department of Immunology, Epsom and St Helier University Hospitals NHS Trust, Carshalton, Surrey, UK.
J Clin Pathol. 2012 Aug;65(8):758-61. doi: 10.1136/jclinpath-2012-200669. Epub 2012 Jun 1.
This study investigated bone marrow plasma cell subsets and monoclonal free light chain concentrations in blood of monoclonal gammopathy patients. 54 bone marrow samples were stained by double immunofluorescence to enumerate cellular subsets making either intact monoclonal immunoglobulin or free light chains only. Blood taken at the same time was assayed for free light chains by an automated immunoassay. Patients were assigned to three cellular population categories: single intact monoclonal immunoglobulin (59%), dual monoclonal immunoglobulin and free light chain only (31%), or single free light chain only (9%). The median affected free light chain concentration of each group was 75 mg/l, 903 mg/l and 3320 mg/l, respectively, but with substantial overlap. In myeloma patients the difference in serum free light chain concentrations between patients with free light chain only marrow cells and those without was statistically significant. Serum free light chain levels >600 mg/l result mostly from marrow cells restricted to free light chain production.
本研究调查了单克隆丙种球蛋白病患者骨髓浆细胞亚群和血液中单克隆游离轻链浓度。对 54 个骨髓样本进行双重免疫荧光染色，以计数仅产生完整单克隆免疫球蛋白或游离轻链的细胞亚群。同时采集的血液通过自动化免疫分析测定游离轻链浓度。患者被分为三个细胞群体类别：单一完整单克隆免疫球蛋白（59%）、双重单克隆免疫球蛋白和游离轻链仅（31%）或单一游离轻链仅（9%）。每个组受影响的游离轻链浓度中位数分别为 75mg/L、903mg/L 和 3320mg/L，但有很大的重叠。在骨髓瘤患者中，仅骨髓细胞产生游离轻链的患者与无游离轻链的患者之间血清游离轻链浓度的差异具有统计学意义。血清游离轻链水平>600mg/L 主要是由于骨髓细胞仅限于游离轻链的产生。
