Ffrench M, Ffrench P, Remy F, Chapuis-Cellier C, Wolowiec D, Ville D, Bryon P A
Laboratoire de Cytologie Analytique, Faculté de Médecine Rockefeller, Lyon, France.
Am J Med. 1995 Jan;98(1):60-6. doi: 10.1016/S0002-9343(99)80081-3.
We investigated the place of direct plasma cell proliferation analysis beside other biologic data in monoclonal gammopathy, particularly the serum level of C-reactive protein (C-RP) PATIENTS: Eighty patients were studied at the time of their diagnosis. Patients with a serum creatinine level greater than 200 mumol/L were excluded.
Plasma cell proliferation analysis was performed after bromodeoxyuridine incorporation and double immunoenzymatic labeling on cytological smears, making determination of the plasma cell labeling index (LI) possible. The other biologic variables studied were related to tumor burden (plasmacytosis, hemoglobin, serum levels of monoclonal immunoglobulin, albumin) or to kidney function (creatinine). beta 2-microglobulin (beta 2-M), C-RP, lactic dehydrogenase (LDH), and calcemia were also assessed.
No correlation was found between LI and serum C-RP. LDH was the sole variable significantly correlated to C-RP (P < 0.01). Besides the biologic parameters used for the staging according to the Durie and Salmon classification, beta 2-M, albumin and LI were significantly different between stages (P < 0.0002, < 0.0004, < 0.00001). LDH and C-RP showed no significant difference. Results were similar when patients with and without bone lesions were analyzed separately. Multivariate analysis ranked these variables as follows with respect to prognostic value: beta 2-M, LI, and age.
Among the variables analyzed, LI is the sole true reflector of cell proliferation. We confirm its diagnostic and prognostic value.
我们研究了在单克隆丙种球蛋白病中，直接浆细胞增殖分析在其他生物学数据中的地位，特别是C反应蛋白（C-RP）的血清水平。
80例患者在诊断时接受研究。血清肌酐水平大于200μmol/L的患者被排除。
在溴脱氧尿苷掺入后，对细胞学涂片进行双免疫酶标记，进行浆细胞增殖分析，从而能够测定浆细胞标记指数（LI）。研究的其他生物学变量与肿瘤负荷（浆细胞增多、血红蛋白、单克隆免疫球蛋白血清水平、白蛋白）或肾功能（肌酐）有关。还评估了β2-微球蛋白（β2-M）、C-RP、乳酸脱氢酶（LDH）和血钙。
未发现LI与血清C-RP之间存在相关性。LDH是唯一与C-RP显著相关的变量（P<0.01）。除了根据Durie和Salmon分类用于分期的生物学参数外，β2-M、白蛋白和LI在各期之间存在显著差异（P<0.0002、<0.0004、<0.00001）。LDH和C-RP无显著差异。分别分析有和无骨病变的患者时，结果相似。多变量分析根据预后价值对这些变量进行如下排序：β2-M、LI和年龄。
在所分析的变量中，LI是细胞增殖的唯一真正反映指标。我们证实了其诊断和预后价值。
