74例多发性骨髓瘤免疫学分型诊断

Immunological Classification and Diagnosis of Multiple Myeloma (Analysis of 74 Cases)

采用Ｍ成分的轻、重链检测法对７４例多发性骨髓瘤（ＭＭ）做免疫学分型诊断。其中４３例（５８．１０％）属ＩｇＧ类，以ＩｇＧ＿１亚类最为常见。其次是轻链病（占１８．９１％）。Ｍ蛋白的电泳迁移率与其所属抗原类型无特定关系，即使同属一亚类和同一轻链型的病例，也可有显著的个体差异；存在由不同ＩｇＧ亚类Ｍ成分构成的双Ｍ病例。同时做血清和尿蛋白电泳对于ＭＭ分型诊断和判断患者肾受累程度具有积极意义。

This paper reports 74 multiple myeloma patients chiefly classified by heavy and light chain detection of myeloma protein (M proteion). The results were as follows: fourty-three out of these cases belonged to the IgG class, including following subclasses-IgG1-k19,IgG1-λ12,IgG2-k,IgG3-λand IgG4-k each one,IgG3-k2, double IgG subclass M protein myleoma cases 4(IgG1-k+IgG3-k, IgG1-λ+IgG3-k, IgG1-λ+IgG4-λ,IgG2-k+IgG3-λ), and heavy chains non-detected 3. Fourteen out of these 74 cases were light chain diseases, of which 9 cases belonged to λtype, 4 were k type, and the other one was a double light chain disease. Thirteen cases belonged to IgA class,(IgA-k7 and IgA-λ6).The other 4 were 3 IgD-λand 1 IgM-k. Our studies disclosed that there were no correlation between electrophoretic mobility and the antigenicity of M protein even within an identical subclass, And the concurrent presence of albumin with BJP in urine may interfere with the routine BJP test and lead to misdiagnosis of light chain disease. The significance on the immunological classification and the observation of patient's renofunction by making serum protein electrophoresis along with urinary protein on same one agarose gel plate was discussed.