免疫固定电泳在诊断多发性骨髓瘤中的作用

Role of immunofixation electrophoresis in the diagnosis of multiple myeloma

目的探讨分析免疫固定电泳在诊断多发性骨髓瘤(MML)中的作用。方法以2014年10月至2016年10月丽水市人民医院收治的110例需进行免疫固定电泳检测的患者为研究对象,对其进行血清M蛋白和浓缩尿中M蛋白的检测,筛选出两种检测均显阳性的患者,并将检测结果与临床资料相比较,对比血清M蛋白和浓缩尿中M蛋白的检测阳性与多发性骨髓瘤之间的关系。结果 110例需进行免疫固定电泳检测的患者中,经临床资料分析,有34例患者为多发性骨髓瘤。这34例患者血清M蛋白的检测显阳性,临床诊断符合率为100.00%;25例患者浓缩尿中M蛋白的检测显阳性,临床诊断符合率为73.53%。血清检验的临床符合率较尿液检验更好,差异具有统计学意义(P<0.05);34例血清M蛋白的检测显阳性的患者中,IgG型21例(61.76%),IgA型8例(23.53%),IgM型3例(8.82%),γ轻链型2例(5.88%)。结论 MML患者采用血清及尿液免疫固定电泳检测,血清M蛋白检测阳性率较浓缩尿中M蛋白的检测阳性率要高,血清及尿液进行的免疫固定电泳检测对MML的诊断、检测及预后判断具有重要的提示作用,临床工作者可以根据电泳图谱对MML进行分型,并制定个体化的治疗方案。

Objective To investigate the role of immunofixation electrophoresis in the diagnosis of multiple myeloma. Methods From October 2014 to October 2016, 110 patients tested by immunofixation electrophoresis were studied. Serum M protein and concentrated urine M protein were detected, positive cases were screened out and compared with clinical data. The correlation of serum M protein and concentrated urine M protein with multiple myeloma was analyzed. Results Among 110 included patients, 34 patients had multiple myeloma by clinical data. Serum M protein was positive in 34 cases, and the coincidence rate of clinical diagnosis was 100.00%. The positive rate of concentrated urine M protein was found in 25 patients, the co- incidence rate of clinical diagnosis was 73.53%. Serum detection was significantly better than urine detection （P〈0.05） . Among the 34 patients with positive serum M protein, 21 cases （61.76%） were IgG type, 8 cases （23.53%） were IgA type, 3 cases （8.82%） were IgM type, and 2 cases （5.88%） were 7 light chain type. Conclusion Serum M protein positive rate is higher than concentrated urine M protein positive rate in multiple myeloma patients, serum and urine immunofixation electrophoresis detection has important implications in multiple myeloma diagnosis, detection and prognosis, clinical physicians can type multiple myeloma based on electrophoretic patterns, and formulate individualized treatment programs.