Igκ、Igλ及Igκ与Igλ比值在多发性骨髓瘤诊断中的作用

Study on the role of Igκ,Igλand Igκ/Igλin diagnosis of multiple myeloma

目的探讨Igκ、Igλ及Igκ与Igλ比值在多发性骨髓瘤(MM)临床诊断中的作用。方法采用HevyliteTM法测定122例MM患者及30例健康者血清Igκ、Igλ水平并计算其比值,同时对MM患者血清进行免疫固定电泳。结果血清免疫固定电泳分型:κIgG型MM 26例(21.31%),λIgG型MM 58例(47.54%);κIgA型MM 14例(11.48%),λIgA型MM 18例(14.75%);κIgM型MM 4例(3.28%),λIgM型MM 2例(1.64%)。κIgG型MM患者血清IgGκ水平中位数为36.900g/L,IgGκ与IgGλ比值的中位数为97.300,均明显高于健康对照组,差异有统计学意义(P<0.05);与之相反,IgGλ水平中位数为0.380g/L,明显低于健康对照组(34.900g/L),差异有统计学意义(P<0.05)。λIgG型MM患者血清中IgGλ水平中位数为34.900g/L,明显高于健康对照组(3.420g/L),差异有统计学意义(P<0.05);与之相反,IgGκ水平中位数为0.495g/L,IgGκ与IgAλ比值中位数为0.016,均明显低于健康对照组,差异有统计学意义(P<0.05)。IgA型MM患者血清中IgAκ、IgAλ水平及IgAκ与IgAλ比值与健康对照组比较,与IgG型MM患者呈相同的变化模式。结论 Igκ、Igλ及Igκ与Igλ比值在MM临床诊断中具有重要价值。

Objective To evaluate the role of Igκ,Igλ and Igκ/Igλ in diagnosis of multiple myeloma（MM）.Methods The serum levels of Igκ,Igλ for 122 MM patients and 30 healthy people were detected by HevyliteTM assay.Then the ratio of Igκ/Igλ was calculated.Immunofixation electrophoresis（IFE）was performed on serum samples of MM patients.Results Serum IFE show：there were 26（21.31%）cases κIgG MM,58（47.54%）cases λIgG MM,14（11.48%）cases κIgA MM,18（14.75%）cases λIgA MM,4（3.28%）cases κIgM MM,2（1.64%）cases λIgM MM, respectively.The median levels of IgGκ and IgGκ/Igλ for κIgG MM patients were 36.900 g/L and 97.300,which were higher than those of control group（ P 〈 0.05）.Contrastly,the median levels of IgGλ were 0.380 g/L,which were lower than that of control group（34.900 g/L）,P〈 0.05.λIgG MM patients had a higher level median （34.900 g/L）than that of control group（3.420 g/L）,P〈 0.05.But the median levels of IgGκ and IgGκ/Igλ for κIgG MM patients were 0.495 g/L and 0.016,which were lower than those of control group（P〈 0.05）.Compared with the control group,the median levels of IgAκ,IgAλ and IgAκ/λ for IgA MM patients showed a simialr trends with IgG MM patients.Conclusion Serum Igκ,Igλ levels and Igκ/Igλ ratio has a significant value in the diagnosis of MM.