Wiedermann D, Wiedermann B, Cídl K, Kodousková V
Neoplasma. 1980;27(4):473-81.
Thirty-four patients with primary macroglobulinemia (Waldenström) were compared with healthy subjects and myeloma patients previously studied regarding their levels of 17 specific serum proteins. Quantitative changes of individual serum proteins were discussed with the respect to their biologic functions. Moreover linear correlations between the serum proteins studied were examined. Selected hematological data at diagnosis of macroglobulinemia have been also reported. The concentration of IgM monoclonal component (MC) was in 88% of macroglobulinemic sera above 1000 mg/dl. If no hyperproteinemia and IgM excess are concerned 5 proteins were found elevated (orosomucoid, alpha1-antitrypsin, ceruloplasmin, C-reactive protein (CRP), hemopexin) and 7 were decreased (prealbumin, albumin, alpha2HS glycoprotein, transferrin, C3-component, IgA, IgD). Differences in mean levels of 4 proteins (haptoglobin, alpha2 macroglobulin, beta2-glycoprotein I, IgG) did not reach statistical significance. CRO was demonstrable in two-thirds of patients and the CRO levels more than 1 mg/dl were noticed in a half of them. changes of phase proteins in macroglobulinemia were similar to those observed in myeloma and other malignancies. In the present series as previously in myeloma no positive relationship could be demonstrated between the concentration of MC and individual acute phase proteins. The levels of polyclonal IgG and IgA, not IgD were found significantly higher in macroglobulinemia than in myeloma, thus polyclonal formula in macroglobulinemia being more favorable. In contrast to myeloma the IgM MC showed at 5% level no significant negative correlation with polyclonal immunoglobulins (IgG, IgA, IgD) among which positive mutual correlations were noticed.
将34例原发性巨球蛋白血症（瓦尔登斯特伦病）患者与健康受试者以及先前研究过的骨髓瘤患者的17种特定血清蛋白水平进行了比较。针对个体血清蛋白的定量变化，结合其生物学功能进行了讨论。此外，还检测了所研究血清蛋白之间的线性相关性。还报告了巨球蛋白血症诊断时的选定血液学数据。88%的巨球蛋白血症血清中IgM单克隆成分（MC）浓度高于1000mg/dl。若不考虑高蛋白血症和IgM过量，发现5种蛋白升高（血清类粘蛋白、α1抗胰蛋白酶、铜蓝蛋白、C反应蛋白（CRP）、血红素结合蛋白），7种蛋白降低（前白蛋白、白蛋白、α2HS糖蛋白、转铁蛋白、C3成分、IgA、IgD）。4种蛋白（触珠蛋白、α2巨球蛋白、β2糖蛋白I、IgG）的平均水平差异未达到统计学意义。三分之二的患者可检测到C反应蛋白，其中一半患者的C反应蛋白水平超过1mg/dl。巨球蛋白血症中急性期蛋白的变化与骨髓瘤和其他恶性肿瘤中观察到的相似。在本系列研究中，与骨髓瘤研究一样，未发现MC浓度与个体急性期蛋白之间存在正相关关系。发现巨球蛋白血症中多克隆IgG和IgA的水平显著高于骨髓瘤，而不是IgD，因此巨球蛋白血症中的多克隆模式更有利。与骨髓瘤不同，IgM MC在5%的水平上与多克隆免疫球蛋白（IgG、IgA、IgD）之间无显著负相关，其中存在正相关关系。
