多发性骨髓瘤患者尿液中完整或片段化免疫球蛋白的高发生率。
High incidence of intact or fragmented immunoglobulin in urine of patients with multiple myeloma.
作者信息
Kraj Maria, Kruk Barbara, Lech-Marańda Ewa, Warzocha Krzysztof, Prochorec-Sobieszek Monika
机构信息
a Department of Diagnostics for Hematology , Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
b Department of Hematology , Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
出版信息
Leuk Lymphoma. 2015;56(12):3348-56. doi: 10.3109/10428194.2015.1037753. Epub 2015 May 13.
In this prospective study we determined the incidence of intact/fragmented immunoglobulin and Bence Jones protein in urine immunofixation using Sebia reagents and HydrasysTM 2 apparatus and compared the results to concentrations of serum free light chains (FLC) assessed using Siemens BNTM II nephelometer and the immunoassay Freelite (Binding Site) in 289 patients with multiple myeloma at diagnosis. It was found that in one third of IgG, IgA and IgD myeloma patients, intact/fragmented immunoglobulin can be detected in urine and is connected with impaired renal function and reduced survival. Urine immunofixation detects monoclonal protein (FLC and intact/fragmented immunoglobulin) in 66-79% of IgG and IgA myeloma patients while serum FLC immunoassay detect it in 82-94% of IgG and IgA myeloma patients. However, the latter method is inadequate for detection of intact/fragmented immunoglobulin in urine. Serum FLC immunoassay and urine immunofixation are complementary methods in diagnosing and monitoring monoclonal protein in patients with myeloma.
在这项前瞻性研究中，我们使用Sebia试剂和HydrasysTM 2仪器测定了尿液免疫固定中完整/片段化免疫球蛋白和本周氏蛋白的发生率，并将结果与289例初诊多发性骨髓瘤患者使用西门子BNTM II散射比浊仪和Freelite免疫测定法（Binding Site公司）评估的血清游离轻链（FLC）浓度进行比较。结果发现，在三分之一的IgG、IgA和IgD骨髓瘤患者中，尿液中可检测到完整/片段化免疫球蛋白，且与肾功能受损和生存率降低有关联性。尿液免疫固定法在66%-79%的IgG和IgA骨髓瘤患者中检测到单克隆蛋白（FLC和完整/片段化免疫球蛋白） ，而血清FLC免疫测定法在82%-94%的IgG和IgA骨髓瘤患者中检测到单克隆蛋白。然而，后一种方法不足以检测尿液中的完整/片段化免疫球蛋白。血清FLC免疫测定法和尿液免疫固定法是诊断和监测骨髓瘤患者单克隆蛋白的互补方法。
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