摘要
轻链病在福建是仅次于IgG型的较常见的多发性骨髓瘤类型。本文11例包括λ型6例、κ型4例,另1例系双轻链病。结果分析表明,轻链病患者血清蛋白电泳不一定有可见的M带;常规尿本周蛋白检测方法失误较多;本周蛋白电泳迁移率可有显著的个体差异;尿中轻链多聚体的形成可导致出现不止一条平行区带。轻链病的确诊需依赖尿轻链检测,并除外本周蛋白阳性的其他类型多发性骨髓瘤。
This paper reports 11 cases of light chain disease (LCD) sequentially found in several coastal cities of Fujian Province.Immunological classification of this group of LCD was as follows:6 belonged to λ type,4 were k type, and 1 was double LCD.We found that LCD was common in Fujian next only to MM of IgG class and accounted for 20% of the total 55 MM cases found in recent years. Several important points should be stressed when making immunological diagnosis of LCD.1) It is well known that in most patients with LCD,M protein or Bence Jones proteinemia(BJPemia)is not detectable by conventional electrophoresis.Our studies show that running serum protein along with urinary BJP on the same one gel plate can allow for the recognition of small and faint band (s) of free light chain in serum,and also provides a rapid and sensitive method (immunofixation) to directly detect urinary light chains. 2) The concurrent presence of albumin with BJP in urine may interfere with the routine BJP test and lead to misdiagnosis.3) As a result of the molecular seiving effect,the presence of light chain polymers in high BJP urine may lead to the presence of several parallel bands on the BJP gel electrophcretic spectrum,4) Determination of light chain in urine is essential for final immunological diagnosis of LCD,but care should be taken,since many patients with other immunological types of MM may have a positive BJP test.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
1993年第4期255-260,共6页
Acta Academiae Medicinae Sinicae
关键词
多发性骨髓瘤
轻链病
免疫学诊断
multiple myeloma
light chain disease
immunological diagnosis