多发性骨髓瘤M蛋白与梅毒血清学假阳性的关系

Relationship between M-Protein of Multiple Myeloma and False Positive Syphilis Serological Results

背景:在对多发性骨髓瘤(multiple myeloma,MM)患者的常规梅毒血清学筛查实验中发现了假阳性现象。目的:探讨MM的M蛋白与梅毒血清学假阳性的关系。方法:通过免疫固定电泳法(immunofixation electrophoresis,IFE)对68例M M患者的M蛋白分型,并对其进行非特异性和特异性的梅毒血清学筛查实验,再将筛查出阳性标本进行梅毒血清学的免疫印迹确认实验,最后分析多发性骨髓瘤患者M蛋白与梅毒血清学假阳性的关系。结果:68例MM患者中的4例梅毒血清学阳性标本,通过进一步的确认实验已明确其结果均为假阳性结果,假阳性率达到了近6%。在我院血液科住院的MM患者中M蛋白类型多以IgG、κ型为主,占绝大多数。其次为IgA、κ型,轻链κ型,总的来说κ∶λ=2.4∶1。与之对应的4例梅毒血清学阳性标本中,2例为IgG、κ型,1例为IgG、λ型,另外1例为IgA、κ型。结论:MM患者的IgG和IgA型的M蛋白导致了MM患者的梅毒血清学假阳性反应,因此确定MM患者的梅毒血清学筛查的阳性结果,应引起临床和检验医生的强烈关注,避免假阳性造成的误诊及其带来的负面影响。

Background:The false positive in conventional syphilis serological test was found in patients with multiple myeloma(MM).Objective:To investigate the relationship between the M- protein of patients with MM and the false positive in conventional syphilis serologic test.Methods:The M- protein of 68 MM cases was typed with immunofixation electrophoresis and 68 cases of MM were screened with non-specific and specific syphilis serologic tests,then the samples with syphilic serological positive were chosen and confirmed with immonobloting test,finally the relationship between M protein of MM and the false positive of syphilis serological test were analysed.Results:Four out of 68 cases showed the positive in syphilis serological test and further were confimed to be false positive by immunoblotting test,the false positive rate was nearly 6%.The M- protein of MM patients in our hospital mostly possessed IgG、κ type,followed by IgA、κ type、light chain k type.In general,κ:λ=2.4:1.Among samples of 4 cases with syphilis serological positive 2 cases were of IgG and k type,1 case was of IgG,λ type,another 1 case was IgA,κtype.Conclusion:The M-protein of IgG and IgA types in MM patients results in syphilis serological false positive reaction.The clinicians and laboratorial technicians should pay a great attention to screen the MM patients for the false positive syphilis serological test so as to avoid the misdiagnosis and subsequent embarassment.