多发性骨髓瘤患者M蛋白标记的临床意义

目的:探讨多发性骨髓瘤(multiple myeloma,MM)患者血清蛋白电泳M蛋白标记的临床意义,观察其定量水平监测疾病进展和评估治疗药物的疗效.方法:对169例患者血清蛋白电泳的M蛋白波峰进行柱状法标记,通过免疫固定电泳(IFE)确诊其免疫分型,同时进行血清总蛋白(TP)、白蛋白(ALB)含量检测.连续追踪25例...

Clinical significance of M protein labeling in patients with multiple myeloma

Objective:To investigate the clinical significance of serum protein electrophoresis M protein peak labeling in patients with multiple myeloma(MM),and to observe its quantitative level to monitor disease progression and evaluate the efficacy of therapeutic drugs.Methods:Column-like labeling was performed on the M-protein peaks that was high and narrow in the serum protein electrophoresis wave graph of 169 patients.The immunophenotype was confirmed by immunofixation electrophoresis (IFE),and serum total protein (TP) and albumin（ALB） were detected simultaneously .Serum protein electrophoresis was continuously followed-up in 25 patients with newly diagnosed multiple myeloma (MM),the M protein wave graph was labeled to obtain the percentage of M protein,and the M protein concentration was converted.Calculation formula:M protein concentration (g/L)=TP concentration(g/L)×M protein percentage(%),and the calculation results were compared.Results:Among 169 patients,49 cases (29.0%) of M protein peaks were observed in the β-region of serum protein electrophoresis,and 120 cases (71.0%) of M protein peaks were observed in γ-region.After IFE classification:48 cases of κ-type IgG type(28.4%),43 cases of λ type IgG type (25.4%),14 cases of κ type IgA type (8.3%),16 cases of λ type IgA type (9.5%),11 cases of κ type IgM (6.5%),3 cases of λ type IgM (1.8%),κ-type IgD type in 2 cases (1.2%),λ-type IgD type in 6 cases (3.6%),free κ light-chain type in 2 cases (1.2%),free λ light-chain type in 8 cases (4.7%),double clone type 1 case (0.6%),and monoclonal bands were not found in 15 cases(8.9%).25 patients with MM chemotherapy evaluation after chemotherapy were followed up and monitored.Albumin was significantly higher than before chemotherapy.There were 4 cases of M protein peak in β-region,the concentrations of β-globulin and M-protein were significantly decreased,and the difference was statistically significant (P＜0.05).There were 21 cases of γ-protein M protein peak.γ-globulin and M protein were significantly decreased (P＜0.05,P＜0.01),among the MM patients with persistent M protein,in the first evaluation,serum TP concentration and M protein concentration decreased significantly,and ALB concentration increased significantly.In the second evaluation,the TP and ALB concentrations tended to be stable to the normal reference interval.The M protein concentration gradually decreased to disappear.Conclusion:Serum protein electrophoresis M protein wave graph labeling is the basis for the diagnosis of MM,macroglobulinemia,amyloidosis and other plasma cell diseases,it can be used as a marker to quantify it,better to provide guidance for monitoring disease progression and evaluating the efficacy of therapeutic drugs.