血清唾液酸在IgA型多发性骨髓瘤诊断和治疗中的临床意义

目的 探讨血清唾液酸(SA)在IgA型多发性骨髓瘤(MM)诊断及治疗中的临床意义.方法 应用生化免疫分析仪测定50名健康体检者及76例MM患者确诊时及治疗后的血清SA水平.结果 76例MM中,IgA型25例,除IgA型外51例(IgG型40例,轻链型7例,不分泌型4例).健康对照及IgA型、IgG型、轻链型、不分泌型、除IgA型外MM患者确诊时血清SA平均水平分别为(570.33±67.72)、(1289.24±325.42)、(585.88±159.12)、(600.77±126.90)、(590.50±100.86)、(588.39±150.90)mg/L,IgA型MM患者血清SA水平高于健康对照及其他各型MM(均P<0.01),而健康对照及其他各型MM间血清SA水平差异无统计学意义(均P>0.05).IgA型MM患者确诊时血清SA水平与血清IgA、球蛋白、骨髓涂片浆细胞数、红细胞沉降率呈正相关(r值分别为0.699、0.753、0.504、0.732,均P<0.05),与血清清蛋白、IgG、血红蛋白、血小板呈负相关(r值分别为-0.712、-0.505、-0.629、-0.596,均P<0.05),与白细胞、血清肌酐、血清IgM、乳酸脱氢酶、血清钙、C反应蛋白、β2微球蛋白不相关(均P>0.05).IgA型MM患者血清SA水平随病情好转而下降,随病情加重而上升.结论 IgA型MM患者血清SA升高,是反映IgA型MM肿瘤负荷量的指标,也可作为其疗效评价的指标.

Clinical significance of serum sialic acid in diagnosis and treatment of IgA type multiple myeloma

Objective To investigate the clinical significance of serum sialic acid (SA) in the diagnosis and treatment of IgA type multiple myeloma (MM). Methods The level of serum SA in 50 healthy subjects and 70 patients with MM were determined. Results In MM group, there were 25 cases of IgA type, 51 cases of other than IgA type (40 cases of IgG type, 7 cases of light chain type MM, 4 cases of non-secreting type MM). In healthy subjects, patients with IgA, IgG, light chain, non-secreting types and other than IgA type, the serum SA levels were (570.33 ± 67.72) mg/ L, (1289.24 ± 325.42) mg/ L, (585.88 ± 159.12) mg/L, (600.77 ± 126.90) mg/L, (590.50 ± 100.86) mg/L, and (588.39 ± 150.90) mg/L. The serum SA level of IgA type patients was higher than those of healthy subjects and other types (all P<0.01), and there was no significant difference among the other groups (all P> 0.05). The serum SA level of IgA type patients had positive correlations with serum IgA, globulin, bone marrow smear myeloma cell population and ESR (r values were 0.699, 0.753, 0.504, and 0.732, all P< 0.05); the serum SA level of IgA type patients had negative correlations with serum albumin, IgG, hemoglobin and platelet (r values were -0.712, -0.505, -0.629, and -0.596, all P< 0.05). The serum SA level of IgA type patients had no correlation with leukocyte, serum creatinine, serum IgM, lactic dehydrogenase, serum calcium, C-reactive protein and β2-microglobulin (all P>0.05). The level of serum SA in IgA type patients decreased with the improvement of the condition, and increased with the severity of the disease. Conclusions In MM patients, serum SA level in IgA type is high. The serum SA is an index for reflecting the tumor load capacity, and can evaluate the therapeutic efficiency of IgA type MM patients.