CAJ | 학술논문

目的探讨血清游离轻链(sFLC)在多发性骨髓瘤(MM)诊断和疗效监测中的临床意义.方法采用免疫比浊法检测62例MM患者在疾病不同阶段sFLC κ与λ浓度,计算其比值.以35例慢性肾功能不全(CRF)患者及62名健康供血者为对照.结果健康对照组sFLC中κ值( 13.25±6.46 )mg/L,λ值(18.39±11.42)mg/L;κ/λ比值0.97±0.64(范围0.33～ 1.61).CRF患者sFLC值为(200.01±299.87) mg/L,λ值为(191.02±245.98 )mg/L,显著高于健康对照组(t=-17.804、-16.894,均P＜0.001)；但κ/λ比值(1.11±0.29)在正常范围内.57例分泌型MM,新诊断IgGκ、IgAκ、IgDκ型MM患者的κ值范围16.20～35 250 mg/L,IgGλ、IgAλ、IgDλ型MM患者的λ值范围为15.70～4885 mg/L.96.5％(55/57)患者存在κ/λ比值异常(＜0.5或＞1.5).治疗后达缓解/平稳期κ、λ水平及κ/λ比值趋于正常.结论 sFLC检测对于MM患者的诊断、治疗效果及疾病复发的监测较常规检测方法更为敏感.
목적 탐토혈청유리경련(sFLC)재다발성골수류(MM)진단화료효감측중적림상의의.방법 채용면역비탁법검측62례MM환자재질병불동계단sFLC κ여λ농도,계산기비치.이35례만성신공능불전(CRF)환자급62명건강공혈자위대조.결과 건강대조조sFLC중κ치( 13.25±6.46 )mg/L,λ치(18.39±11.42)mg/L;κ/λ비치0.97±0.64(범위0.33～ 1.61).CRF환자sFLC치위(200.01±299.87) mg/L,λ치위(191.02±245.98 )mg/L,현저고우건강대조조(t=-17.804、-16.894,균P＜0.001)；단κ/λ비치(1.11±0.29)재정상범위내.57례분비형MM,신진단IgGκ、IgAκ、IgDκ형MM환자적κ치범위16.20～35 250 mg/L,IgGλ、IgAλ、IgDλ형MM환자적λ치범위위15.70～4885 mg/L.96.5％(55/57)환자존재κ/λ비치이상(＜0.5혹＞1.5).치료후체완해/평은기κ、λ수평급κ/λ비치추우정상.결론 sFLC검측대우MM환자적진단、치료효과급질병복발적감측교상규검측방법경위민감.
Objective To evaluate clinical significance of serum free light chains (sFLC) in diagnosis and response to the therapies of patients with multiple myeloma (MM).Methods sFLC (κ,λ and κ / λ ratio)were examed by immumoassay from 62 patients with MM at different stage. The results were analyzed associated with clinical data,and 35 cases of chronic renal failure (CRF) patients and 62 cases of healthy donors were taken as controls.Results Medium sFLC of normal κ value was (13.25±6.46) mg/L,λ value was (18.39±11.42) mg/L; and κ / λ ratio was (0.97±0.64) mg/L (range 0.33-1.61).sFLC κ and λ of CRF patients were (200.01±299.87) mg/L,(191.02±245.98) mg/L,significantly higher than that of the normal control group (t =-17.804,-16.894,both P ＜ 0.001),but the κ/λ ratio was at normal range (1.11±0.29).κ value range was at 16.20- 35 250 mg/L in newly diagnosed intact immunoglobulin MM patients with IgGκ,IgAκ and IgDκ type.The range of λ values was 15.70-4885 mg/L in IgGλ,IgAλ,IgDλ type,and κ/λ ratio was abnormal in 96.5 ％ (55/57) patients (＜0.5 or ＞1.5).The κ,λ value and κ/λ ratio were close to that of the normal after remmision.Conclusion sFLC ( κ,λ,and κ / λ ratio) are very good monitoring markers for MM.