Johansen P, Jensen M K
Acta Pathol Microbiol Scand A. 1980 Nov;88(6):377-82. doi: 10.1111/j.1699-0463.1980.tb02509.x.
Peripheral blood smears and bone-marrow smears from 29 patients with malignant M-components (25 with multiple myeloma and 4 with malignant lymphoma), 13 patients with benign monoclonal gammopathy (BMG), and 20 patients with polyclonal reactive plasmacytosis were examined by leucocyte alkaline phosphatase score (LAP-score) and by acid phosphatase score in plasma cells from bone-marrow smears. Furthermore, tissue sections from marrow biopsies from all patients were examined by the three-layer unlabelled immunoperoxidase technique to detect cytoplasmic immunoglobulin. The LAP-score was significantly higher in patients with malignant M-components than in patients with BMG and also higher in IgA and IgG myeloma than in IgA and IgG BMG, but the latter difference was not significant. Furthermore, a significant positive correlation between paraprotein concentration and LAP-score was found in multiple myeloma. Acid phosphatase score in plasma cells showed no clear distinction between multiple myeloma and BMG. Immunohistochemical examination showed a distinct monoclonal pattern in both multiple myeloma and BMG, allowing identification of the M-component which in all cases corresponded to the M-component detected by serum examination. Cells producing immunoglobulin classes not matching the M-component were more rare in multiple myeloma than in BMG, but the difference between the two conditions was quantitative and allowed no clear distinction.
对29例伴有恶性M成分的患者（25例多发性骨髓瘤患者和4例恶性淋巴瘤患者）、13例良性单克隆丙种球蛋白病（BMG）患者以及20例多克隆反应性浆细胞增多症患者的外周血涂片和骨髓涂片进行了白细胞碱性磷酸酶评分（LAP评分）以及骨髓涂片浆细胞酸性磷酸酶评分检测。此外，采用三层未标记免疫过氧化物酶技术对所有患者骨髓活检组织切片进行检测，以检测细胞质免疫球蛋白。伴有恶性M成分的患者LAP评分显著高于BMG患者，IgA和IgG型骨髓瘤患者的LAP评分也高于IgA和IgG型BMG患者，但后一差异不显著。此外，在多发性骨髓瘤患者中发现副蛋白浓度与LAP评分之间存在显著正相关。浆细胞酸性磷酸酶评分在多发性骨髓瘤和BMG之间未显示出明显差异。免疫组织化学检查显示多发性骨髓瘤和BMG均呈现明显的单克隆模式，从而能够识别M成分，在所有病例中该M成分均与血清检测所发现的M成分一致。在多发性骨髓瘤中，产生与M成分不匹配免疫球蛋白类别的细胞比BMG中更为少见，但两种情况之间的差异是定量的，无法进行明确区分。
