Ong F, Hermans J, Noordijk E M, De Kieviet W, Seelen P J, Wijermans P W, Kluin-Nelemans J C
Comprehensive Cancer Centre West, Leiden, The Netherlands.
Leuk Lymphoma. 1997 Nov;27(5-6):495-501. doi: 10.3109/10428199709058316.
Diagnostic systems for monoclonal gammopathies use bone marrow and X-ray examinations to exclude multiple myeloma (MM). Data from a population-based registry of unselected patients with paraproteinemia indicate that these tests are often done only when MM is suspected. We used 441 randomly selected patients to develop a simple four point "Myeloma Risk Score" based on two readily available laboratory tests. One point was given for paraprotein concentration > or = 10 g/l, one point for IgG and IgA, and two points for IgD and light chains only. A score of 0 or 1 indicated a low risk for MM, with scores of 2 and 3 signifying high risks. Sensitivity, specificity, positive and negative predictive value (PV) for the Myeloma Risk Score in the training sample were 92%, 88%, 79%, and 96% respectively. Extrapolating these results to a larger cohort showed that 90% of patients with a monoclonal gammopathy could be classified correctly as having MM or a non-myeloma condition. The Myeloma Risk Score can identify patients with a paraproteinemia at risk for MM, and who are therefore candidates for bone marrow and X-ray examination.
单克隆丙种球蛋白病的诊断系统利用骨髓检查和X光检查来排除多发性骨髓瘤（MM）。来自一个基于人群的未选择的副蛋白血症患者登记处的数据表明，这些检查通常仅在怀疑患有MM时才进行。我们使用441名随机选择的患者，基于两项易于获得的实验室检查，制定了一个简单的四分“骨髓瘤风险评分”。副蛋白浓度≥10 g/l得1分，IgG和IgA得1分，仅IgD和轻链得2分。得分为0或1表明MM风险低，得分为2和3表示高风险。训练样本中骨髓瘤风险评分的敏感性、特异性、阳性和阴性预测值（PV）分别为92%、88%、79%和96%。将这些结果外推至更大的队列显示，90%的单克隆丙种球蛋白病患者可被正确分类为患有MM或非骨髓瘤疾病。骨髓瘤风险评分可以识别有患MM风险的副蛋白血症患者，因此这些患者是骨髓检查和X光检查的候选对象。
