296例血清免疫固定电泳检测结果分析

Analysis of the Results of 296 Cases by Immunofixation Electrophoresis

目的:通过免疫固定电泳(IFE)检测血清特异性单克隆免疫球蛋白(M蛋白),为多发性骨髓瘤(MM)分型诊断提供依据。方法:对296例血清总蛋白异常或血清蛋白电泳异常患者血清进行IFE,比较蛋白定量、血清蛋白电泳和IFE对MM的诊断价值,并分析M带所处位置对MM诊断和分型的作用。结果:296例中有109例患者诊断为MM。血清总蛋白测定、血清蛋白电泳、血清IFE三种方法临床诊断敏感性分别为92.66%、88.99%、100.00%;特异性分别为16.04%、72.72%、97.32%。IgG型、IgM型MM患者血清M蛋白均在γ区,IgA型MM患者的血清M蛋白多在β区或β-γ区,轻链型MM患者M蛋白各球蛋白区域均可出现。结论:应用IFE对MM患者血清M蛋白进行诊断和分型,其特异性好,灵敏度高,是有重要价值的临床诊断方法。

Objective：To detect the specific monoclonal immunoglobulin（M protein）in patients with multiple myeloma（MM） by immunofixation electrophoresis and provide evidences of diagnosis and classification for multiple myeloma.Method：The 296 cases with abnormal total protein or unusual bands in serum protein electrophoresis were analyzed by immunofixation electrophoresis on Sebia electrophoresis.The clinical value of serum total protein,serum protein electrophoresis and immunofixation electrophoresis were discussed.The relationship between the location of the belt M and the clinical diagnosis and typing of multiple myeloma were compared and analyzed.Results：Of all the patients,there were 109 cases were diagnosed multiple myeloma.The sensitivity of the total protein,serum protein electrophoresis and immunofixation electrophoresis were 92.66%,88.99%,100.00% and the specificity were 16.04%,72.72%,97.33% respectively.The M proteins in patients of IgG and IgM MM always located in γ zone but the M protein in patients of IgA MM appeared in the β zone or β-γ zone.The M proteins in patients with light chains MM could occur from α2 to γ zone.Conclusion：Immunofixation electrophoresis shows excellent high sensitivity and specificity in the determination and classification for multiple myeloma.