Bernett A, Allerhand J, Efremides A P, Clejan S
Clin Biochem. 1986 Aug;19(4):244-9. doi: 10.1016/s0009-9120(86)80035-2.
Since 1968, our Clinical Chemistry laboratory has been performing protein electrophoresis on sera of patients with total protein levels of over 85.0 g/L and under 55.0 g/L. Monoclonal gammopathies were found in 534 cases. Immunoelectrophoresis was carried out using antisera to the heavy chains gamma, alpha, mu, delta, and epsilon, and to the light chains kappa and lambda. Urine from these patients was tested for Bence-Jones protein. Records and smears, when available, were examined for clinical or hematologic evidence of multiple myeloma and other lymphoid malignancies. Sixty-five percent of these 534 cases were referred to the laboratory with a provisional diagnosis of plasmacytoma but 35% were not clinically suspected. Twenty-two cases with gammopathy, but no clinical or hematologic symptoms of plasma cell dyscrasia, were selected and followed up. Eight of these patients (36%) had converted to malignancy by the end of ten years. These results show the value of screening for abnormal proteins and the need for a long-term follow-up in such patients, prior to diagnosis of plasma cell dyscrasia.
自1968年以来，我们的临床化学实验室一直在对总蛋白水平超过85.0 g/L和低于55.0 g/L的患者血清进行蛋白电泳。共发现534例单克隆丙种球蛋白病。使用针对γ、α、μ、δ和ε重链以及κ和λ轻链的抗血清进行免疫电泳。检测这些患者的尿液中是否存在本-周蛋白。如有记录和涂片，检查是否有多发性骨髓瘤和其他淋巴恶性肿瘤的临床或血液学证据。这534例病例中，65%是在初步诊断为浆细胞瘤后转诊至实验室的，但35%在临床上未被怀疑。选择22例有丙种球蛋白病但无浆细胞发育异常临床或血液学症状的患者进行随访。到十年结束时，这些患者中有8例（36%）已转变为恶性肿瘤。这些结果表明了筛查异常蛋白的价值以及在此类患者诊断浆细胞发育异常之前进行长期随访的必要性。
