多发性骨髓瘤血、尿总轻链与游离轻链相符率比较及其临床意义

The comparison of accordant rate of total light chains and free light chains in serum and urine and its clinical significance of muitiple myeloma

目的：比较多发性骨髓瘤（MM）患者血总轻链和游离轻链相符率与尿总轻链和游离轻链相符率的差异性，探讨造成差异性的可能原因及其临床意义。方法检测128例 MM患者血、尿游离轻链和总轻链的浓度，分别统计计算血、尿总轻链和游离轻链的相符率并进行比较。结果128例 MM患者中有72例血总轻链和游离轻链变化完全相符，相符率为56．25％；有119例尿总轻链和游离轻链检测完全相符，相符率为92．97％，两者差异有统计学意义。结论血总轻链与血游离轻链检测相符率较低，尿总轻链与尿游离轻链相符率很高，因此在基层医院可以用尿总轻链替代尿游离轻链的检测。

Objective To compare the accordant rate of total light chains and free light chains in serum and urine of mutiple myeloma（MM）patients,and to discuss its clinical significance.Methods 128 MMpatients were included and detected for free and total light chains of serum and urine.Calculate and compare the accordant rates of free and total light chains in serum and urine respectively.Results Among the 128 MM patients,72 cases of serum free light chains（sFLCs）and serum total light chains （sTLCs）were accordant,the accordant rate was 56.25%.119 cases of urinary free light chains（uFLCs） and total light chains（uTLCs）were accordant,the accordant rate was 92.97%.There was a significant difference between the two groups.Conclusion In MM patients,the accordant rate of the TLC and FLC in serum is not high,nevertheless the accordant rate of the TLC and FLC in urine is very high.Therefore, the detection of uFLCs can be substituted by uTLCs in primary hospitals.