CAJ | 학술논문

　　目的探讨免疫固定电泳技术在IgD型多发性骨髓瘤（MM）分型中的应用价值，研究其实验室特征。方法从1356例MM患者中，筛选出在免疫固定电泳结果中只有轻链而不出现IgGAM重链的血清样本，用抗游离轻链的单克隆抗体及抗IgD、抗IgE单克隆抗体再进行免疫固定电泳，对IgD型M蛋白阳性患者血清进行免疫球蛋白定量，对其尿液标本进行本周蛋白定性检测。结果1356例MM患者中有56例为IgD型，占MM的4.1%，其中53例为IgD-λ型，3例为IgD-κ型；51例呈血清游离轻链阳性；56例患者中仅2例尿液本周氏蛋白呈阴性，54例呈阳性；患者血清的IgG、IgA、IgM与正常人比较结果偏低。结论利用抗游离轻链的单克隆抗体及抗IgD、抗IgE抗体进行免疫固定电泳，对多发性骨髓瘤的分型诊断具有重要意义。
　　목적탐토면역고정전영기술재IgD형다발성골수류（MM）분형중적응용개치，연구기실험실특정。방법종1356례MM환자중，사선출재면역고정전영결과중지유경련이불출현IgGAM중련적혈청양본，용항유리경련적단극륭항체급항IgD、항IgE단극륭항체재진행면역고정전영，대IgD형M단백양성환자혈청진행면역구단백정량，대기뇨액표본진행본주단백정성검측。결과1356례MM환자중유56례위IgD형，점MM적4.1%，기중53례위IgD-λ형，3례위IgD-κ형；51례정혈청유리경련양성；56례환자중부2례뇨액본주씨단백정음성，54례정양성；환자혈청적IgG、IgA、IgM여정상인비교결과편저。결론이용항유리경련적단극륭항체급항IgD、항IgE항체진행면역고정전영，대다발성골수류적분형진단구유중요의의。
Objective To investigate the applicability and laboratory attributes of IgD multiple myeloma(MM) typing in the immunofixation electrophoresis. Methods Samples contained the light chains without IgGAM heavy chain were selected from 1356 MM patients. Both the anti-free-light-chain monoclonal antibody and anti-IgD and anti-IgE of monoclonal antibody were used to detect IgD M-protein-positive serum for immunoglobulin quantitative analysis. As the qualitative detection of their urine samples, a Bence-Jones protein test was to apply. Results 56 cases were detected with the IgD type which was 4.1%of the total 1356 MM patients. 53 and 3 cases were IgD-λ-type and IgD-κrespectively while 51 cases were reported serum-free-light chain-positive. Only two cases of the urine Bence-Jones protein were negative, whereas predominance was positive. Lower common value of IgG, IgA, IgM were discovered in patients’ serum. Conclusion The combination use of anti-free-light-chain monoclonal antibody and anti-IgD and anti-IgE antibody alike for genotyping of multiple myeloma’s diagnosis has a signiifcant impact on immunoifxation electrophoresis. The per se status may be a good predictive marker of sensitivity.