联合检测血清尿酸、β2微球蛋白和尿液轻链在多发性骨髓瘤早期诊断中的应用

Value of combination detection of uric acid,β-2 globulin and urine κ,λ light chain in early diagnosis of multiple myeloma

目的探讨联合检测血清尿酸(UA)、β2微球蛋白(β2-MG)和尿液κ、λ轻链在多发性骨髓瘤(multiple myeloma,MM)早期诊断中的应用价值。方法选择96例MM患者(MM组)和85例健康体检者(对照组)作为观察对象,分别采用尿酸酶法和免疫透射比浊法测定血清中的UA、β2-MG含量;采用散射比浊法测定尿液中κ、λ轻链含量。结果不同性别、不同年龄段MM患者血清UA、β2-MG和尿液κ、λ轻链水平比较,差异均无显著性(P>0.05),MM组患者三项指标与对照组比较差异均有显著性(P<0.05)。联合检测血清UA、β2-MG和尿液κ、λ轻链用于诊断MM的灵敏度和特异度均高于三者单项检测和两两联合检测;三项平行联合检测灵敏度为93.32%,系列联合检测特异度为97.90%。结论联合检测血清UA、β2-MG和尿液κ、λ轻链可用于MM的早期诊断,具有较高的临床价值。

Objective To investigate the value of the combination detection of uric acid,β-2 globulin and urineκ,λlight chain in the early diagnosis of multiple myeloma(MM).Methods Uric acid enzyme method and immune transmission turbidimetry method were used to detect the serum levels of uric acid andβ-2 globulin in 96 patients with MM(MM group)and 85 healthy subjects(healthy control group).Theκandλlevel were determined by Siemens BN Pro specific protein analyzer.Results The levels of uric acid,β-2 globulin and urineκandλlight chain in MM group were statistically significant when compared with those in healthy control groups(P<0.05).The combination detection of uric acid,β-2 globulin and urineκandλlight chain showed higher sensitivity and specificity than individual assay or combined detection of any of the two methods.The sensitivity and the specificity was respectively 93.32%and 97.90%respectively.All three indicators showed no significant difference in patients with different gender or age.Conclusion The combination detection of uric acid,β-2 globulin and urineκandλlight chain level can be used as the early diagnosis of MM and shows great clinical application prospect.