摘要
目的探讨多发性骨髓瘤(MM)的常见实验室诊断指标对分型、治疗和预后的意义。方法观察40例MM患者骨髓细胞形态及细胞化学染色情况,并进行血清蛋白电泳、免疫固定电泳及血清β2-微球蛋白(β2-MG)、乳酸脱氢酶(LDH)检测。结果 MM患者的骨髓瘤细胞具有较高的异质性,酸性磷酸酶染色(ACP),酸性α-醋酸萘酚酯酶染色(ANAE),过典酸-雪夫染色(PAS)对骨髓瘤细胞分型具有鉴别诊断意义;血清蛋白电泳M蛋白检出率为84.0%,59.0%出现在γ区,25.0%出现于β与γ区间,16.0%出现于β区;免疫固定电泳对M蛋白检出率为95.0%,其中IgG型55.0%I、gA型25.0%、轻链型15.0%;LDH检测显示ISS分期Ⅰ期、Ⅱ期、Ⅲ期对应MM患者的LDH平均值分别为198.70 U/L2、32.34 U/L3、61.67 U/L,与血清β2-MG有较好的平行性。结论骨髓细胞形态与细胞化学染色对MM有鉴别诊断意义;免疫固定电泳对M蛋白检出率高于血清蛋白电泳,且前者对MM的临床分期及预后更具有临床意义;血清β2-MG与LDH的含量与MM患者病情呈正相关,可作为临床疗效及预后判断指标。
Objective To explore prognostic significance of the diagnostic method for multiple myeloma.Methods Observe morphology and cytochemical staining for bone morrow in 40 patients with multiple myeloma,then do serum protein eleltrophoresis and immunofixation electrophoresis,and detect serum β2-microglobulin and lactate dehydrogenase.Results Marrow plasma is alloplastic,myeloma cell can be distinguished by acid phosphatase stain,acid α-naphthol acetate esterase and periodic acid-Schiff reaction.The detection rate of M protein by serum protein eleltrophoresis is 84.0%,which locate 59.0% in gamma zone,25.0% between beta and gamma zone,16.0% in beta zone;The detection rate of M protein by immunofixation electrophoresis is 95.0%,Monoclonal IgG accounts for 55.0%,IgA for approximately 25.0%,a monoclonal light chain is found in the serum of 15.0% of patients;according to ISS trying,tye I with the mean of lactate dehydrogenase for 198.70 U/L,tye II for 232.34 U/L and tye III for 361.67 U/L,which get good relation to β2-microglobulin.Conclusion morphology and cytochemicla is valuable for the diagnosis of multiple myeloma;immunofixation electrophoresis is higher than serum protein eleltrophoresis in detection rate for M-protein,which is more valuable for clinical typin and prognosis to multiple myeloma;actate dehydrogenase have a good relation to β2-microglobulin,which also have a good relation to the state of the disease,and they are guide for prognosis and curative effect.
出处
《中国实验诊断学》
北大核心
2011年第4期675-677,共3页
Chinese Journal of Laboratory Diagnosis
关键词
多发性骨髓瘤
诊断
预后
multiple myeloma
diagnosis
prognosis
