20例初诊多发性骨髓瘤血清游离轻链测定及其临床意义

本研究测定多发性骨髓瘤（multiple myeloma，MM）患者血清游离轻链（serum free light chain，sFLC）数值，并与血清总轻链（游离＋结合）比较，探讨sFLC测定在MM患者中的临床意义。应用免疫比浊法测定20例初治MM患者及20例正常对照人群sFLC数值，同期测定患者血清总轻链数值，计算sFLC及血轻链结果的K／h比率，其中18例行免疫固定电泳（immunofixation electrophoresis，IFE）检查。结果表明：20例多发性骨髓瘤患者sFLC数值及K／h比值较正常人群均明显异常（P〈0．01），其敏感性明显高于血清轻链（P〈0．01）。结论：应用免疫比浊法测定sFLC并结合K／h比率在MM诊断中有重要的价值，sFLC检测可作为MM诊断的重要指标之一。

Measurement of Serum Free Light Chains and Its Clinical Significance in 20 Newly Diagnosed Patients of Multiple Myeloma

The objective of this study was to explore the clinical significance of measuring serum free light chains (sFLC) and to compare with serum total light chains (free and binded) in multiple myeloma (MM). sFLC in 20 newly diagnosed MM patients and 20 cases of healthy people as control were measured by immuno-nephelometric assays; the serum light chains and kappa/lambda ratio were measured in all patients, while immunofixation electrophoresis (IFE) tests were carried out at the same time in 18 out of 20 patients. The results showed that the abnormality of serum free light chains and kappa/lambda ratio were found in all of the 20 newly diagnosed MM patients (p < 0.01). The measurement of sFLC showed higher sensitivity than the total serum chains (p < 0.01). It is concluded that the method testing sFLC by immuno-nephelometric assay combined with kappa/lambda ratio is valuable for MM diagnosis, and the measurement of sFLC can be used as one of indicators for MM diagnosis.