Zhu An-You, Zhu Fang-Bing, Wang Feng-Chao, Zhang Lun-Jun, Ma Yue, Hu Jian-Guo
Department of Clinical Laboratorial Examination, The First Affliated Hospital of Bengbu Medical College,Bengbu 233004,Anhui Province, China.
Department of Hematology, The First Affliated Hospital of Bengbu Medical College,Bengbu 233004,Anhui Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2017 Oct;25(5):1454-1459. doi: 10.7534/j.issn.1009-2137.2017.05.030.
To explore the relationship between serum total light chain κ/λ ratio (sTLC-κ/λ) and proportion of bone marrow plasma cells (BMPC) in patients with IgG type and IgA type multiple myeloma (MM) and its clinical significance.
The levels of serum IgG, IgA, κ type and λ type total light chain were detected in 79 newly diagnosed patients with IgG type (n=52) and IgA type (n=27) MM by immuno-nephelometric assay and the sTLC-κ/λ ratio was calculated. The proportion of BMPC was determined by bone marrow smears in the corresponding period, and the changes in sTLC-κ/λ ratio and the proportion of BMPC were observed in 19 patients with IgG type(n=16) and IgA type (n=3) MM undergoing treatment, 26 cases of non-phasmocytic proliferative diseases were enrolled in control group.
In MM patients with IgGκ type and IgAκ type, the sTLC-κ/λ ratio was significantly higher than that in the control group (P<0.01), while in MM patients with IgGλ type and IgAλ type, the sTLC-κ/λ ratio was significantly lower than that in the control group (P<0.01). In MM patients with IgGκ, the sTLC-κ/λ ratio was significantly higher than that in MM patients with IgAκ(P<0.01), while the sTLC-κ/λ ratio in MM patients with IgGλ was significantly lower than that in MM patients with IgAλ. The sTLC-κ/λ ratios in MM patients with IgGκ and IgAκ were positively correlated with the concentrations of IgG (r=0.778,P=0.000) and IgA (r=0.601,P=0.039), while the sTLC-κ/λ ratios of patients with IgGλ and IgAλ were negativily correlated with the IgG(r=-0.586,P=0.01) and IgA level(r=-0.718,P=0.003). In addition, a correlation between each type MM was not found except the IgGκ type MM which had a positive correlation between the sTLC-κ/λ ratio and proportion of BMPC (r=0.579,P=0.002). Nonetheless, 18 of 19 patients with IgG type and IgA type MM undergoing treatment showed concordance between the sTLC-κ/λ ratio and proportion of BMPC change.
There is a lower correlation between the sTLC-κ/λ ratio and the proportion of BMPC in MM patients with IgG type and IgA type, but there is a high concordance between the sTLC-κ/λ ratio and the proportion of BMPC change in the same patient and it suggests that the sTLC-κ/λ ratio plays an important role in the diagnosis and monitoring of IgG type and IgA type MM.
探讨IgG型和IgA型多发性骨髓瘤（MM）患者血清总轻链κ/λ比值（sTLC-κ/λ）与骨髓浆细胞比例（BMPC）的关系及其临床意义。
采用免疫比浊法检测79例新诊断的IgG型（n=52）和IgA型（n=27）MM患者血清IgG、IgA、κ型和λ型总轻链水平，并计算sTLC-κ/λ比值。同期通过骨髓涂片测定BMPC比例，观察19例接受治疗的IgG型（n=16）和IgA型（n=3）MM患者sTLC-κ/λ比值及BMPC比例的变化，选取26例非浆细胞增殖性疾病患者作为对照组。
IgGκ型和IgAκ型MM患者的sTLC-κ/λ比值显著高于对照组（P<0.01），而IgGλ型和IgAλ型MM患者的sTLC-κ/λ比值显著低于对照组（P<0.01）。IgGκ型MM患者的sTLC-κ/λ比值显著高于IgAκ型MM患者（P<
