血清免疫球蛋白及血尿液轻链水平对老年多发性骨髓瘤的诊断价值OACSTPCD
Diagnostic value of serum immunoglobulin and blood and urine light chain in elderly patients with multiple myeloma
目的 分析血清免疫球蛋白(Ig)及血、尿液轻链(κ、λ)水平对老年多发性骨髓瘤(MM)的诊断价值.方法 回顾性分析2021年1月-2023年12月青岛市胶州中心医院收治的72例初诊MM患者(MM组)的临床资料,另选取同期门诊骨髓报告为增生性贫血患者108例(非MM组)和体检健康者80名(对照组),检测并比较3组及不同R-ISS分期患者血清免疫球蛋白(IgG、IgM、IgA)及血、尿液κ、λ水平,绘制各项指标的受试者工作特征(ROC)曲线,分析多项指标联合检测在MM患者诊断中的价值.结果 MM组血清IgG及血、尿κ轻链水平高于非MM组和对照组,血、尿λ轻链水平低于非MM组和对照组,非MM组血清IgG及血、尿κ轻链水平高于对照组,血、尿λ轻链水平低于对照组,差异均有统计学意义(均P＜0.05),3组血清IgA、IgM水平差异无统计学意义(P＞0.05).ISS-Ⅲ期患者血清IgG及血、尿κ轻链水平高于Ⅱ期患者(P＜0.05),Ⅱ期患者血清IgG及血、尿κ轻链水平高于Ⅰ期患者(P＜0.05),不同ISS分期患者血清IgA、IgM及血、尿λ轻链水平差异无统计学意义(P＞0.05).ROC曲线分析显示,血清IgG水平和血、尿液κ、λ轻链水平联合诊断老年MM的敏感度为91.67％,特异度为93.52％,曲线下面积(AUC)为0.971,均高于单独诊断(P＜0.05).结论 血清IgG和血、尿液轻链水平联合检测对老年MM的诊断价值较高,并可评估患者病情程度.
Objective To analyze the diagnostic value of serum immunoglobulin(Ig)and blood and urine light chain(κ,λ)in elderly patients with multiple myeloma(MM).Methods The clinical data of 72 newly diagnosed MM patients(MM group)admitted to Jiaozhou Central Hospital of Qingdao from January 2021 to December 2023 were retrospectively ana-lyzed.In addition,108 patients with hyperplastic anemia reported in the outpatient department(non-MM group)and 80 health-y subjects(control group)were selected during the same period.The levels of serum immunoglobulin(IgG,IgM,IgA),and blood and urine κ and λ-light chain were detected and compared among the 3 groups and patients with different R-ISS stages.Receiver operating characteristic(ROC)curves of each indicator were drawn to analyze the value of combined detection of multiple indicators in the diagnosis of MM patients.Results The levels of serum IgG and blood and urine K-light chain of the MM group were higher than those of other two groups,and the levels of blood and urine λ-light chain were lower than those of other two groups;the levels of serum IgG and blood and urine K-light chain of the non-MM group were higher than those of the control group,and the levels of blood and urine λ-light chain were lower than those of the control group.The differences were statistically significant(P＜0.05).There was no significant difference in the levels of serum IgA and IgM among the 3 groups(P＞0.05).The levels of serum IgG and blood and urinary K-light chain of the stage ISS-Ⅲ patients were higher than those of the stage ISS-Ⅱ patients(P＜0.05),and the levels of serum IgG and blood and urinary K-light chain of the stage ISS-11 pa-tients were higher than those of the ISS-Ⅰ stage patients(P＜0.05).There was no significant difference in the levels of serum IgA,IgM and blood and urine λ-light chain among patients with different ISS stages(P＞0.05).ROC curve analysis showed that the sensitivity,specificity and area under the curve(AUC)of the combined detection of serum IgG and blood and urine κand λ-light chains for the diagnosis of MM in elderly patients were 91.67％,93.52％,and 0.971,respectively,which were higher than those of any single diagnosis(P＜0.05).Conclusion The combined detection of the levels of serum IgG and blood and urine light chain is of high diagnostic value in elderly patients with MM,and can evaluate the degree of disease.
韩冰;王淑萍;王英连;刘艳丽
青岛市胶州中心医院急诊内科,山东青岛 266300青岛市胶州中心医院重症医学科,山东青岛 266300
老年多发性骨髓瘤免疫球蛋白G免疫球蛋白M免疫球蛋白A血液轻链尿液轻链诊断价值
elderlymultiple myelomaimmunoglobulin Gimmunoglobulin Mimmunoglobulin Ablood light chainurine light chaindiagnostic value
《老年医学与保健》 2024 (004)
977-980,1032 / 5
山东省青岛市2020年度医药科研指导计划(2020-WJZD120)
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