老年人意义未明的单克隆免疫球蛋白血症的转归

The outcome of monoclonal gammopathy of undetermined significance in elderly patients

目的 探讨老年人意义未明的单克隆免疫球蛋白血症（MGUS）的转归.方法 对我院14例MGUS患者转归进行回顾性分析,总结MGUS临床特征及转归时间,探讨单克隆免疫球蛋白浓度变化.结果 MGUS无多发性骨髓瘤（MM）的临床表现,从MGUS到MM转归时间为4～20年,平均10年;MM主要为IgA型和IgG型,其中IgA型6例,IgG型6例,轻链型2例;MGUS患者免疫球蛋白浓度总体呈现逐年上升趋势,呈折线型上升者占少数.结论 单克隆免疫球蛋白升高有向MM发展的可能,对于MGUS患者需密切观察,避免漏诊和误诊.

Objective To explore the outcome of monoclonal gammopathy of undetermined significance （MGUS）. Methods The data from 14 MGUS patients in our hospital including clinical features, outcome and change of M protein concentration were analyzed retrospectively. Results The MGUS didn＇t have the clinical manifestations of multiple myeloma （MM）, the time of outcome from MGUS to MM was about 4-20 years （mean time, 10 years）. The most types of MM were IgA and IgG, 6 cases were IgA type, 6 cases were IgG type and 2 cases were light chain type. The concentration of immune globulin in general showed an upward trend year by year. A few showed fold lines ascend. Conclusions The elevated monoclonal immunoglobulin may develop into MM after many years. We must follow up frequently to avoid error diagnosis and missed diagnosis.