Ong F, Kaiser U, Seelen P J, Hermans J, Wijermans P W, de Kieviet W, Jaques G, Kluin-Nelemans J C
Comprehensive Cancer Center West, Leiden, The Netherlands.
Blood. 1996 Jan 15;87(2):712-6.
Serum neural cell adhesion molecule (NCAM) has been described as a prognostic marker in multiple myeloma (MM). Both C-reactive protein (CRP) and beta 2-microglobulin (beta 2M) are established prognostic markers in MM. We tested the diagnostic value of these markers in 212 serum samples of patients with paraproteinemia registered prospectively in a population-based registry. Sixty patients had MM and 152 had other monoclonal gammopathies (hematologic diseases [48], paraneoplastic disease [35], autoimmune disease [15], and monoclonal gammopathy of undetermined significance [56]). CRP and beta 2M had wide and overlapping ranges in all diagnostic categories. However, serum neural cell adhesion molecule (NCAM) was low (< 20 U/mL) in all but 4 of 152 nonmyeloma cases and high (> or = 20 U/mL) in 31 (52%) of the 60 MM cases. Two patients with non-Hodgkin's lymphoma, 1 with chronic lymphatic leukemia, and 1 with autoimmune disease had serum NCAM values between 20 and 30 U/mL. In a discriminant analysis in which serum NCAM, CRP, beta 2M, paraprotein type and concentration, hemoglobin, leukocyte and thrombocyte counts, creatinine, corrected calcium, lactate dehydrogenase, and alkaline phosphatase were included, paraprotein type and concentration and serum NCAM turned out to be the best combination of parameters predicting whether a patient had MM, with 89% of cases being correctly classified. Even without bone marrow and x-ray examinations, serum NCAM, in combination with paraprotein type and concentration, can differentiate between MM and nonmyeloma patients.
血清神经细胞黏附分子（NCAM）已被描述为多发性骨髓瘤（MM）的一种预后标志物。C反应蛋白（CRP）和β2微球蛋白（β2M）都是MM中已确立的预后标志物。我们在一个基于人群的登记处前瞻性登记的212例副蛋白血症患者的血清样本中测试了这些标志物的诊断价值。60例患者患有MM，152例患有其他单克隆丙种球蛋白病（血液系统疾病[48例]、副肿瘤性疾病[35例]、自身免疫性疾病[15例]和意义未明的单克隆丙种球蛋白病[56例]）。CRP和β2M在所有诊断类别中范围广泛且有重叠。然而，在152例非骨髓瘤病例中，除4例之外，其余病例的血清神经细胞黏附分子（NCAM）均较低（<20 U/mL），而在60例MM病例中有31例（52%）较高（≥20 U/mL）。2例非霍奇金淋巴瘤患者、1例慢性淋巴细胞白血病患者和1例自身免疫性疾病患者的血清NCAM值在20至30 U/mL之间。在一项判别分析中，纳入了血清NCAM、CRP、β2M、副蛋白类型和浓度、血红蛋白、白细胞和血小板计数、肌酐、校正钙、乳酸脱氢酶和碱性磷酸酶，结果显示副蛋白类型和浓度以及血清NCAM是预测患者是否患有MM的最佳参数组合，89%的病例被正确分类。即使不进行骨髓和X线检查，血清NCAM与副蛋白类型和浓度相结合，也能够区分MM患者和非MM患者。
