Zhao Dan, Jiang Jia-Qi, Lin Lin
Department of Clinical Laboratorial Examination, The First Hospital Affiliated to Dalian Medical University, Dalian 116000, Liaoning Province, China.
Department of Clinical Laboratorial Examination, The First Hospital Affiliated to Dalian Medical University, Dalian 116000, Liaoning Province, China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2019 Aug;27(4):1173-1178. doi: 10.19746/j.cnki.issn.1009-2137.2019.04.029.
To analyze the clinical significance of serum free light chain (sFLC) and sFLC-κ/λ ratio in patients with newly diagnosed multiple myeloma (MM), so as to provide the theoretical basis for the diagnosis, treatment and prognosis of MM patients.
A total of 43 patients newly diagnosed as MM in our hospital and 40 cases of other diseases that could cause sFLC increase were selcted. The clinical features of newly diagnosed MM patients were analyzed. On the basis of the type of sFLC, MM patients were divided into sFLC-κ and sFLC-λ group. The correlation of sFLC with clinical index in two groups was analyzed. The difference of sFLC-κ/λ ratio between MM and non-MM patients was analyzed. According to whether the involved/uninvolved sFLC ratio was greater than 100, the MM patients were divided into the low ratio and the high ratio group. The clinical index of these 2 groups were analyzed.
Among MM patients, IgG type was the most. In sFLC-κ and -λ groups, the hemoglobin level negatively correlated with sFLC (r=-0.307, r=-0.494, P＜0.05), and the serum β2 microglobulin level positively correlated with sFLC (r=0.453, r=0.689, P＜0.05), and myeloma cells ratio also positively correlated with sFLC (r=0.307, r=0.309, P＜0.05). The concentration of albumin, lactate dehydrogenase and serum calcium did not correlate with sFLC (P＞0.05). The serum creatinine level also did not correlate with sFLC in the sFLC-κ group (P＞0.05), but in the sFLC-λ group they were obviously positive (r=0.697, P＜0.01). The ratio of sFLC-κ/λ ＜0.26 or ＞1.65 in MM patients was higher than that of non-MM patients, and the ratio of involved/uninvolved sFLC≥100 in MM patients was also higher than that of non-MM patients with statistically significant differences (P＜0.01). The levels of serum albumin, creatinine and β2 microglobulin, as well as myeloma cell ratio and ISS international staging of the patients between 2 groups were significantly different (P＜0.05), while the differences in sex, age and levels of hemoglobin, lactate dehydrogenase and blood calcium were not significant between the 2 groups (P＞0.05).
The light chain type λ in MM patients correlates with renal damage. The abnormalities of sFLC-κ/λ ratio occur mostly in MM patients. The MM patients with involved/uninvolosed sFLC ratio ≥100 show the severe symptoms and poor prognosis.
分析血清游离轻链（sFLC）及sFLC-κ/λ比值在新诊断多发性骨髓瘤（MM）患者中的临床意义，为MM患者的诊断、治疗及预后提供理论依据。
选取我院新诊断为MM的43例患者及40例可导致sFLC升高的其他疾病患者。分析新诊断MM患者的临床特征。根据sFLC类型，将MM患者分为sFLC-κ组和sFLC-λ组。分析两组中sFLC与临床指标的相关性。分析MM患者与非MM患者sFLC-κ/λ比值的差异。根据受累/未受累sFLC比值是否大于100，将MM患者分为低比值组和高比值组。分析这两组的临床指标。
MM患者中，IgG型最多。在sFLC-κ组和-λ组中，血红蛋白水平与sFLC呈负相关（r=-0.307，r=-0.494，P＜0.05），血清β2微球蛋白水平与sFLC呈正相关（r=0.453，r=0.689，P＜0.05），骨髓瘤细胞比例也与sFLC呈正相关（r=0.307，r=0.309，P＜0.05）。白蛋白、乳酸脱氢酶及血清钙浓度与sFLC无相关性（P＞0.05）。sFLC-κ组中血清肌酐水平与sFLC也无相关性（P＞0.05），但在sFLC-λ组中二者呈明显正相关（r=0.697，P＜0.01）。MM患者中sFLC-κ/λ比值＜0.26或＞1.65的比例高于非MM患者，MM患者中受累/未受累sFLC≥100的比例也高于非MM患者，差异有统计学意义（P＜0.01）。两组患者的血清白蛋白、肌酐及β2微球蛋白水平，以及骨髓瘤细胞比例和国际分期系统（ISS）分期差异有统计学意义（P＜0.05），而两组患者的性别、年龄及血红蛋白、乳酸脱氢酶和血钙水平差异无统计学意义（P＞0.05）。
MM患者中轻链λ型与肾损害相关。sFLC-κ/λ比值异常多见于MM患者。受累/未受累sFLC比值≥100的MM患者症状严重且预后较差。
