Brown R D, Joshua D E, Ioannidis R A, Kronenberg H
Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Aust N Z J Med. 1989 Jun;19(3):226-32. doi: 10.1111/j.1445-5994.1989.tb00251.x.
Serum thymidine kinase (STK) levels have recently been used to detect tumour regression and progression in a number of hematological malignancies. In this study, patients with myeloma were monitored longitudinally for STK and several other potentially useful tumour markers to determine which laboratory parameters are the most useful for differentiating between stable and progressive disease. STK was determined by radioenzyme assay, lymphocyte surface markers were analysed by flowcytometry, plasma cell labelling index (LI) by immunofluorescence with anti BU-1, serum B2-microglobulin (SB2M) by radioimmunoassay and M proteins by radial immunodiffusion. Detailed multiparameter longitudinal investigations of 5 patients and ongoing studies of 70 other patients suggest that STK is a more reliable marker of progressive disease than either SB2M, LI, M-protein or CD10 positive lymphocytes. A rise in STK during the emergence of progressive disease at least paralleled and usually preceded any change in the other parameters which often did not change at all. All samples from patients with progressive disease (n = 29) had a STK above the normal range (0-5U/l) whereas 76% of patients in clear stable disease had a STK within the normal range. All samples (n = 34) from patients with light chain isotype suppression (LCIS) had STK values of less than 12 U/L and 82% of samples (n = 33) from patients without LCIS had a STK above the normal range (0-5U/L). The correlation between STK and LI was r = 0.65; p less than 0.001 (n = 21). The radioenzyme assay for STK is simple, reproducible and a valuable tool for monitoring patients with myeloma and when used in conjunction with other clinical and laboratory investigations, aids in the separation of patients with stable myeloma from patients whose disease is progressive.
血清胸苷激酶（STK）水平最近已被用于检测多种血液系统恶性肿瘤的肿瘤消退和进展情况。在本研究中，对骨髓瘤患者进行了STK及其他几种可能有用的肿瘤标志物的纵向监测，以确定哪些实验室参数对于区分稳定期和进展期疾病最有用。STK通过放射酶法测定，淋巴细胞表面标志物通过流式细胞术分析，浆细胞标记指数（LI）通过抗BU - 1免疫荧光法测定，血清β2 - 微球蛋白（SB2M）通过放射免疫测定法测定，M蛋白通过放射免疫扩散法测定。对5例患者进行的详细多参数纵向研究以及对其他70例患者正在进行的研究表明，与SB2M、LI、M蛋白或CD10阳性淋巴细胞相比，STK是进展期疾病更可靠的标志物。在进展期疾病出现期间，STK的升高至少与其他参数的任何变化平行，并且通常先于其他参数的变化，而其他参数往往根本没有变化。进展期疾病患者（n = 29）的所有样本STK均高于正常范围（0 - 5U/L），而病情明确稳定的患者中有76%的STK在正常范围内。轻链同种型抑制（LCIS）患者的所有样本（n = 34）的STK值均小于12 U/L，无LCIS患者的样本（n = 33）中有82%的STK高于正常范围（0 - 5U/L）。STK与LI之间的相关性为r = 0.65；p小于0.001（n = 21）。STK的放射酶测定法简单、可重复，是监测骨髓瘤患者的有价值工具，当与其他临床和实验室检查结合使用时，有助于区分稳定期骨髓瘤患者和疾病进展期患者。
