FLC-ELISA用于多发性骨髓瘤早期诊断的临床评价

Clinical Evaluation of Immunoglobulin Free Light Chain ELISA for Early Diagnosis of Multiple Myeloma

目的对酶联免疫吸附法测定免疫球蛋白κ和λ自由轻链(FLC-ELISA)用于多发性骨髓瘤早期诊断进行临床评价。方法应用一种新型酶联免疫吸附法来测定多发性骨髓瘤病人血清及尿液中的免疫球蛋白κ和λ自由轻链并与免疫电泳法和免疫比浊光散射法测定的结果进行比较。结果 40例多发性骨髓瘤病人 FLC-ELISA总检出率为100％,而免疫固定电泳法和免疫比浊光散射法的总检出率则分别为57．5％和85．5％。同时,病人样品的测试还表明酶联免疫吸附法可以将多发性骨髓瘤的诊断提前两年以上。结论用酶联免疫吸附法来测定免疫球蛋白κ和λ自由轻链,具有较高的灵敏度,精确性和可重复性,适用于临床多发性骨髓瘤病的早期检测,同时对此疾病进程的跟踪及治疗效果的评价也具有重要意义。

Objective To evaluate the measurement of kappa and lambda immunoglobulin free light chains (FLC) in patient samples using a new enzyme-linked immunosorbent assay for early diagnosis of multiple myeloma. Methods An ELISA method for quantifying kappa and lambda free light chains were used to study serum and urine samples from patients with multiple myeloma, and the results were compared with those obtained using immunofixation electrophoresis and nephelometric immunoassay methods. Results The FLC-ELISA method had great successful rate in identifying the multiple myeloma in all 40 myeloma patients.In contrast, immunofixation electrophoresis and nephelometric immunoassay could only identify 57.5% and 85.5% of the multiple myeloma in all the myeloma patients, respectively. Furthermore, retrospective diagnosis of specimens obtained from patient indicated that the ELISA method could help early diagnosis of the disease by over two years. Conclusion The ELISA method for measuring free light chains is sensitive, accurate and reproducible. Therefore it is a useful tool for early diagnosis of multiple myeloma, monitoring the disease progression and evaluating treatment responses.