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多发性骨髓瘤的免疫化学研究。

Immunochemical studies in multiple myeloma.

作者信息

Thakar Y S, Chande C, Pande S, Dhanvijay A G, Shrikhande A V, Saoji A M

机构信息

Department of Microbiology, Government Medical College, Nagpur, Maharashtra, India.

出版信息

Indian J Cancer. 1997 Dec;34(4):151-8.

PMID:9715537
Abstract

The study deals with a total of 72 patients with Plasma cell dyscrasias (PCD) selected on the basis of atypical plasmacytosis in the bone marrow aspirate and radiological evidence of osteolytic lesions. Males(48) outnumbered the females (24). Pathological fracture and paraplegia was the commonest presenting symptom encountered in 38 patients. Electrophoresis of serum for 'M' band and Immunoelectrophoretic analysis of the serum revealed IgG myeloma in 40 patients followed by, IgA myeloma(13), Light chain disease (12) and other variants in remaining seven cases. The urinary Bence Jones proteins were detected in a total of 34 cases and was frequently encountered with IgA myeloma (7 out of 13) compared with IgG myeloma (13 out of 40) when analysed in Disc electrophoresis. Kappa light chain was observed in 21 cases and lambda counterpart in nine cases without any clinical significance. One case of solitary myeloma terminated in characteristic multicentric multiple myelomatosis within a span of six months in the sequential follow up study. We recommend the triangular approach to diagnosis of paraproteinemia with a special emphasis on immunoelectrophoresis for typing multiple myeloma and allied disorders along with disc electrophoresis for the demonstration of urinary Bence Jones protein in the routine set up.

摘要

该研究共涉及72例浆细胞异常增生症(PCD)患者,这些患者是根据骨髓穿刺液中的非典型浆细胞增多症以及溶骨性病变的放射学证据挑选出来的。男性(48例)多于女性(24例)。病理性骨折和截瘫是38例患者中最常见的首发症状。血清“M”带电泳和血清免疫电泳分析显示,40例患者为IgG骨髓瘤,其次是IgA骨髓瘤(13例)、轻链病(12例),其余7例为其他类型。总共34例检测到尿本-周蛋白,在圆盘电泳分析中,与IgG骨髓瘤(40例中的13例)相比,IgA骨髓瘤(13例中的7例)中更常出现尿本-周蛋白。观察到21例κ轻链和9例λ轻链,无任何临床意义。在一项连续随访研究中,1例孤立性骨髓瘤在6个月内发展为典型的多中心性多发性骨髓瘤。我们推荐采用三角法诊断副蛋白血症,特别强调免疫电泳用于多发性骨髓瘤及相关疾病的分型,同时在常规检查中采用圆盘电泳来检测尿本-周蛋白。

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