Objective: To investigate the expression and clinical significance of serum free light chain (sFLC) in patients with monoclonal gammopathy (MG).
Methods: The peripheral blood of 98 patients with MG and 30 healthy volunteers were collected. The level of sFLC was detected by immunoturbidimetry, and the value of sFLC in diagnosis, disease severity, and efficacy evaluation was analyzed.
Results: Among 98 MG patients, there were 58 males and 40 females, 45 cases of monoclonal gammopathy of renal significance (MGRS), 33 cases of monoclonal gammopathy of undetermined significance (MGUS), 20 cases of hematological malignancy (HM), 58 cases of IgG type, 26 cases of IgA type, 7 cases of IgM type, 5 cases of light chain type, 2 cases of non-secreting type, 35 cases of κ type, 63 cases of λ type, 53 cases of renal insufficiency, 45 cases of normal renal function. The expression levels of sFLC-κ and sFLC-λ in MG patients were significantly higher than those of the control group (P <0.01). The expression levels of sFLC-κ and sFLC-λ in HM patients were significantly higher than MGRS and MGUS patients, and in MGRS patients were also significantly higher than MGUS patients (P <0.05). Patients with abnormal renal function had higher expression levels of sFLC-κ and sFLC-λ than patients with normal renal function (P <0.01). sFLC-κ and sFLC-λ were positively correlated with the expression level of globulin (r =0.392, r =0.435) and β2-MG (r =0.403, r =0.468) in MG patients, as well as serum creatinine in patients with abnormal renal function (r =0.586, r =0.631), while no significant correlation was found with age, sex, albumin, lactate dehydrogenase, and serum calcium. After treatment, the levels of sFLC-κ and sFLC-λ were significantly decreased (P <0.01).
Conclusion: sFLC is significantly elevated in MG patients and can be quickly detected with high sensitivity, which is helpful for the diagnosis of disease type, judgment of disease severity, and evaluation of therapy.
题目: 血清游离轻链在单克隆球蛋白血症中的临床意义.
目的: 探讨血清游离轻链（sFLC）在单克隆免疫球蛋白血症（MG）患者中的表达水平及其临床意义。.
方法: 收集98例MG患者和30例健康志愿者外周血，采用免疫比浊法检测sFLC水平，并分析sFLC对MG患者的诊断、疾病严重程度以及疗效评估的价值。.
结果: 98例MG患者中，男性58例，女性40例；具有肾脏意义的单克隆球蛋白血症（MGRS）45例，意义未明的单克隆球蛋白血症（MGUS）33例，血液系统肿瘤20例；IgG型58例，IgA型26例，IgM型7例，轻链型5例，不分泌型2例；κ型35例，λ型63例；肾功能异常53例，肾功能正常45例。MG患者外周血中sFLC-κ和sFLC-λ表达水平相比对照组均显著升高（P <0.01）。血液系统肿瘤患者sFLC-κ和sFLC-λ表达水平显著高于MGRS和MGUS患者（P <0.05），而MGRS患者又显著高于MGUS患者（P <0.05）。肾功能异常者sFLC-κ和sFLC-λ表达水平显著高于肾功能正常者（P <0.01）。sFLC-κ和sFLC-λ与MG患者的球蛋白（r =0.392，r =0.435）、 β2-微球蛋白水平呈正相关（r =0.403，r =0.468），在伴肾功能异常的患者中，与血肌酐水平亦呈正相关（r =0.586，r = 0.631），与年龄、性别、白蛋白、乳酸脱氢酶、血钙等指标均未见明显相关性。经过治疗，患者sFLC-κ和sFLC-λ的表达水平均显著下降（P <0.01）。.
结论: sFLC水平在MG患者中显著升高，是一个可以快速检测、敏感度高，有助于疾病类型诊断、病情严重程度判定和疗效评估的新指标。.
Keywords: diagnosis; monoclonal gammopathy; serum free light chain; treatment outcome.