血清游离轻链检测在多发性骨髓瘤诊治中作用的临床评价

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目的:检测正常人群血清游离轻链(sFLC)水平,确定我院sFLC正常参考值范围,并研究其与性别、年龄的相关性。通过检测多发性骨髓瘤(MM)患者sFLC水平探讨其在MM诊断及化疗疗效评价中的作用。方法:选取健康体检者存留标本403例,应用免疫散射比浊法测定sFLC水平得出sFLC正常参考值范围。选取明确诊断为MM的58例初诊患者,对32例MM患者进行治疗反应的观察。结果:我院sFLC正常参考值范围为κFLC:5.81~24.04mg/L,λFLC:6.72~22.81mg/L,游离轻链比值(ratio of FLC,rFLC):0.59~1.46,sFLC水平及rFLC与性别及年龄无关。58例初诊MM患者血清κFLC、λFLC及rFLC阳性率为100%,血清免疫固定电泳(IFE)阳性率为98.3%,血清蛋白电泳(SPE)阳性率为92.3%,免疫球蛋白(Ig)定量检测阳性率为91.1%,而尿游离轻链(uFLC)检测阳性率为55%。结论:我院sFLC正常参考值范围与国外报道略有不同,sFLC及rFLC与性别及年龄无关。在MM诊断方面,sFLC检测的敏感性优于IFE、uFLC、SPE、Ig定量。sFLC的检测对于判断病情及化疗疗效监测具有重要意义。 Objective: To detect the level of serum free light chain (sFLC) in normal population, to determine the normal reference range of sFLC in our hospital, and to study its correlation with gender and age. SFLC levels in patients with multiple myeloma (MM) were investigated to evaluate the role of sFLC in the evaluation of MM diagnosis and chemotherapy. Methods: 403 healthy subjects were selected, and the sFLC level was determined by immune nephelometry to get the normal reference range of sFLC. Fifty-eight newly diagnosed patients with definite diagnosis of MM were selected and the response to treatment was observed in 32 MM patients. Results: The normal reference value of sFLC in our hospital ranged from 5.81 to 24.04 mg / L, λFLC: 6.72 to 22.81 mg / L, ratio of free FLC (rFLC): 0.59 to 1.46, sFLC level, rFLC and gender Has nothing to do with age. The positive rate of serum NF-κB, λFLC and rFLC in 58 newly diagnosed MM patients was 100%, the positive rate of IFE was 98.3%, and the positive rate of serum protein electrophoresis (SPE) was 92.3%. The immunoglobulin (Ig) The positive rate was 91.1%, while the positive rate of urinary free light chain (uFLC) was 55%. Conclusion: The normal reference range of sFLC in our hospital is slightly different from that of foreign reports. SFLC and rFLC have no relation with gender and age. In the MM diagnosis, sFLC detection sensitivity than IFE, uFLC, SPE, Ig quantitative. The detection of sFLC is of great significance for judging the condition and monitoring the curative effect of chemotherapy.
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