M蛋白成分浓度在单克隆丙种球蛋白病初始分类中的诊断价值

Diagnostic value of the concentration of M-component in initial classification of monoclonal gammopathy.

作者信息

Møller-Petersen J, Schmidt E B

出版信息

Scand J Haematol. 1986 Mar;36(3):295-301. doi: 10.1111/j.1600-0609.1986.tb01737.x.

DOI:10.1111/j.1600-0609.1986.tb01737.x

Abstract

The diagnostic value of the concentration of a serum M-component in initial classification of monoclonal gammopathy into malignant monoclonal gammopathy (MMG) and monoclonal gammopathy of undetermined significance (MGUS) was evaluated in 315 consecutive individuals with IgG, IgA or IgM type M-components. The final diagnosis was MMG in 84 and MGUS in 231 patients. Serum concentration was significantly highest in MMG, but for all 3 kinds of M-components, overlapping serum concentrations between MMG and MGUS were found. Highest efficiency was reached with a serum concentration of 30.2 g/l for IgG, 26.6 g/l for IgA and 22.7 g/l for IgM. Using these values, an initial correct classification was achieved in 0.90 of IgG M-components, in 0.91 of IgA M-components and in 0.79 of IgM M-components. Normal levels of uninvolved immunoglobulins were found to point strongly to MGUS.

摘要

在315例连续的具有IgG、IgA或IgM型M蛋白成分的个体中，评估血清M蛋白成分浓度在单克隆丙种球蛋白病初步分类为恶性单克隆丙种球蛋白病（MMG）和意义未明的单克隆丙种球蛋白病（MGUS）中的诊断价值。最终诊断为MMG的有84例，MGUS的有231例。MMG患者的血清浓度显著最高，但对于所有3种M蛋白成分，均发现MMG和MGUS之间存在血清浓度重叠。对于IgG，血清浓度为30.2 g/l时效率最高；对于IgA，为26.6 g/l；对于IgM，为22.7 g/l。利用这些值，IgG M蛋白成分中有0.90、IgA M蛋白成分中有0.91、IgM M蛋白成分中有0.79实现了初步正确分类。发现未受累免疫球蛋白水平正常强烈提示为MGUS。