多发性骨髓瘤轻链型与非轻链型实验室检查结果比较

Comparison of the laboratory test results of light chain and non- light chain multiple myeloma

目的评估并比较初治轻链型与非轻链型多发性骨髓瘤(MM)患者实验室检查各指标异常情况。方法比较本院自2011年1月-2016年1月共105例初治轻链型与非轻链型MM患者各实验室检查结果(轻链型31例,非轻链型74例)。结果轻链型患者中Cr水平及异常比例明显高于非轻链型,差异有统计学意义(P=0.03),而轻链型Cys-C水平与非轻链型差异无统计学意义(P=0.57)。轻链型患者原始和幼稚浆/总浆高于非轻链型,差异有统计学意义(P=0.02)。轻链型患者的LDH、β_2M和ALB水平明显高于非轻链型,差异有统计学意义(P<0.05),而ISS分期差异无统计学意义(P=0.38)。结论轻链型患者初诊时肿瘤负荷更大,疾病进展可能更快。

Objective To evaluate and compare the abnormality of the laboratory test results of newly diagnosed light chain and non- light chain multiple myeloma（ MM）. Methods The laboratory test results of 105 newly diagnosed light chain（ n = 31）and non- light chain（ n = 74） multiple myeloma patients admitted into our hospital from January 2011 to January 2016 were evaluated and compared. Results Light chain type patients had significantly higher creatinine level and abnormal percentage than non- light chain type patients,with the difference statistically significant（ P = 0. 03）,while the cystatin- C level of light chain type patients had no difference with the non- light chain type patients（ P = 0. 57）. The ratio of plasmablasts and proplasmacytes / all plasmacytic cells in light chain type patients were significantly higher than non- light chain type patients,with the differences statistically significant（ P = 0. 02）. Light chain type patients also had significantly higher LDH,β2M and ALB level than non- light chain type patients,with the differences not statistically significant（ P〈0. 05）,while there was no statistical significance on the the difference in ISS（ P = 0. 38）. Conclusion In newly diagnosed patients,light chain type patients have heavier tumor burden and may progress faster than non- light chain type multiple myeloma patients.