Hübel K, Hallek M
Klinik I für Innere Medizin, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Internist (Berl). 2013 Jun;54(6):709-14. doi: 10.1007/s00108-012-3215-2.
Monoclonal gammopathy of undetermined significance (MGUS) and monoclonal B lymphocytosis (MBL) are asymptomatic premalignant conditions which can progress to a symptomatic disease state requiring therapy. Considering the high prevalence rate of these disorders, precursor patients are often diagnosed during routine clinical examinations. Only a minor portion of cases progress to overt malignancies, which raises the question of how to identify patients with the probability of progression. In recent years improvements in the understanding of the pathogenesis of both disorders led to the development of risk models and the estimation of the individual risk of progression. The definition of high-risk and low-risk patients allows a tailored clinical management. This report provides information on the biology, risk stratification, diagnosis, and follow-up of patients with MGUS and MBL.
意义未明的单克隆丙种球蛋白病（MGUS）和单克隆B淋巴细胞增多症（MBL）是无症状的癌前病变，可进展为需要治疗的有症状疾病状态。鉴于这些疾病的高患病率，前驱患者常在常规临床检查中被诊断出来。只有一小部分病例会进展为明显的恶性肿瘤，这就引出了如何识别有进展可能性的患者的问题。近年来，对这两种疾病发病机制认识的提高导致了风险模型的发展以及对个体进展风险的评估。高危和低危患者的定义有助于进行个性化的临床管理。本报告提供了有关MGUS和MBL患者的生物学、风险分层、诊断及随访的信息。
