实验室指标及骨髓形态学检查对多发性骨髓瘤的诊断价值分析

Analysis of diagnostic value of laboratory indexes and marrow morphology examination in multiple myeloma

目的:探讨实验室指标及骨髓形态学检查对多发性骨髓瘤(MM)的诊断价值.方法:选取江苏省南通市肿瘤医院检验科收治的56例经临床诊断确诊的MM患者作为研究对象,通过实验室检查项目检测患者红细胞沉降率、血清总蛋白及免疫球蛋白的含量,同时在高倍镜下观察MM患者骨髓细胞形态及特征.结果:56例患者中红细胞沉降率升高的占96.43%,血清总蛋白含量升高的占85.72%;血清球蛋白含量升高的占89.29%,血清球蛋白含量正常的占7.14%,血清球蛋白含量降低的占7.14%;血清白蛋白降低的占92.86%.MM患者血清免疫球蛋白为κ轻链型的比例大于γ轻链型,差异有统计学意义(P<0.05);MM患者骨髓细胞增生程度较多表现为极度活跃或明显活跃;疾病分期越高,骨髓细胞增生程度越活跃.结论:红细胞沉降率、血清总蛋白、免疫球蛋白及骨髓形态学检查对临床诊断MM有一定的提示作用,以上实验室检查项目联合检验具有一定的灵敏度与特异性,可以根据生化指标对MM进行初步的临床诊断及疾病分型.

AIM： To discuss the diagnostic value of laboratory indexes and marrow morphology examination in multiple myeloma （MM）. METHODS： A total of 56 cases of patients with MM diagnosed by clinical examination were selected as the objects of study. Erythrocyte sedimentation rate （ESR）, content of total serum protein and immunoglobulin of patients were detected by laboratory test items. At the same time, the morphology and char- acteristics of bone marrow cells of patients with MM were observed at high magnification microscope. RESULTS： In all, patients with raised erythrocyte sedimentation rate were accounted for 96.43%, patients with raised content of total serum protein were accounted for 85.72% ; Patients with raised content of serum glob- ulin were accounted for 89.29%, patients with normal levels of content of serum globulin were accounted for 7.14%, patients with decreased content of serum globulin were accounted for 7.14% ; Patients with decreased content of serum albumin were accounted for 92.86%. The ratio of serum immunoglobulin of g light chain was greater than that of 3, light chain ; The degree of hone marrow cell proliferation of patients with MM was extremely active or active, and the difference was statistically significant compared with other proliferative degree （P〈0.05）. The higher the stage of disease, the more active the degree of bone marrow cell prolifera- tion （P〈 0.05）. CONLUSION ： Erythrocyte sedimentation rate, total serum protein, immunoglobulin and bone marrow morphology examination has certain implications for the clinical diagnosis of MM. The above joint inspection of laboratory test items has certain sensitivity and specificity. Preliminary clinical diagnosis and classification of diseases on MM can be carried out according to the biochemical indexes.