Gupta Ritu, Dahiya Meetu, Kumar Lalit, Shekhar Varun, Sharma Atul, Ramakrishnan Lakshmy, Sharma Om Dutt, Begum Abida
Laboratory Oncology Unit, Dr. B.R.A. Institute-Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Laboratory Oncology Unit, Dr. B.R.A. Institute-Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Clin Lymphoma Myeloma Leuk. 2018 Sep;18(9):e345-e350. doi: 10.1016/j.clml.2018.06.005. Epub 2018 Jun 12.
We sought to determine the prevalence of monoclonal gammopathy of undetermined significance (MGUS) in a hospital-based cohort in India.
From March 2015 to May 2015, 3429 patients (age range, 40-88 years) were enrolled in the present study. Of the 3429 enrolled patients, 2354 (68.6%) were men and 1075 (31.4%) were women. Serum samples were collected from all patients and analyzed using serum protein electrophoresis (SPEP). The positive SPEP samples were subjected to immunofixation. The patients with positive results for both SPEP and immunofixation were registered in the oncology department and investigated further for plasma cell dyscrasias.
Of the 3429 study patients, 49 (1.43%) were found to have MGUS, and multiple myeloma was diagnosed in another 6 (0.17%). The prevalence rate of MGUS in patients aged 40 to 49, 50 to 59, 60 to 69, and 70 to 80 years was 0.83%, 1%, 2.62%, and 1.75%, respectively. Of the 49 MGUS patients, 5 (10.2%) were in the high-intermediate risk category using the Mayo Clinic criteria for risk stratification. At 30 months of follow-up, 1 patient in the high-intermediate category had developed multiple myeloma.
To the best of our knowledge, the present study is the first systematic study on the prevalence of MGUS in an Indian population. The overall prevalence of MGUS was 1.43% in the evaluated Indian cohort, lower than that reported for white and black populations. The incidental detection of 6 subjects with multiple myeloma of 3429 screened subjects in our study was high compared with the reported incidence of multiple myeloma in India of only 1.9 per 100,000 persons. This finding indicates the need to create awareness about myeloma-related symptoms and screening studies in appropriate age groups, at least in the hospital-based setting.
我们试图确定印度一个以医院为基础的队列中意义未明的单克隆丙种球蛋白病（MGUS）的患病率。
2015年3月至2015年5月，3429例患者（年龄范围40 - 88岁）纳入本研究。在3429例纳入患者中，2354例（68.6%）为男性，1075例（31.4%）为女性。收集所有患者的血清样本并采用血清蛋白电泳（SPEP）进行分析。对SPEP阳性样本进行免疫固定电泳。SPEP和免疫固定电泳结果均为阳性的患者在肿瘤科登记，并进一步调查浆细胞异常增殖性疾病。
在3429例研究患者中，49例（1.43%）被发现患有MGUS，另有6例（0.17%）被诊断为多发性骨髓瘤。40至49岁、50至59岁、60至69岁和70至80岁患者中MGUS的患病率分别为0.83%、1%、2.62%和1.75%。根据梅奥诊所风险分层标准，49例MGUS患者中有5例（10.2%）属于高中危类别。在30个月的随访中，1例高中危类别患者发展为多发性骨髓瘤。
据我们所知，本研究是关于印度人群中MGUS患病率的首次系统性研究。在评估的印度队列中，MGUS的总体患病率为1.43%，低于白种人和黑种人群的报道患病率。在我们的研究中，3429例筛查对象中有6例偶然检测出多发性骨髓瘤，与印度报道的每10万人仅1.9例的多发性骨髓瘤发病率相比偏高。这一发现表明，至少在以医院为基础的环境中，有必要在适当年龄组提高对骨髓瘤相关症状和筛查研究的认识。
