The Role Of Immunofixation Electrophoresis In Multiple Myeloma Parting

Objectives(1) To study the value of immunofixation electrophoresis in the diagnosis and typing of multiple myeloma.(2) To compare the significances in diagnosis and treatment of multiple myeloma of different electrophoresis methods and different sample electrophoreses.MethodBlood and urine samples of 120 patients diagnosed with multiple myeloma were collected in Henan Province People’s Hospital during 2014-2015. Among the 120 patients, 86 were male and 34 were female, and the median age was 62.5(42-68)years old. All the diagnoses of the 120 patients meet the criteria of 2003 International Myeloma Working Group(IMWG), 2008 WHO, and 2013 NCCN. Serum protein electrophoresis, immunofixation electrophoresis and urine protein electrophoresis were conducted on the samples of each and every patient.Results(1) Out of the 120 cases, M protein was detected in 117 cases by immunofixation electrophoresis, 71 cases by serum protein electrophoresis; 64 cases by urine proteinelectrophoresis. Chi-square test was carried out to compare the proportions of the three groups of test results. The results indicate that the Chi-square test results between each group were statistically significant(P<0.05).(2) Out of the 120 cases, M protein was detected in 117 cases by immunofixation electrophoresis, among which 69 cases were type IgG, accounting for 58.9%; 20 cases were type IgA, accounting for 17.1%; 13 cases were type IgM, accounting for11.1%; 3 cases were type IgD, accounting for 2.5%; 1 case was type IgE, accounting for 0.8%; 3 cases were double clone, accounting for 2.5%; 8 cases were light chain type, accounting for 6.8%. M protein was detected in 71 cases by serum protein electrophoreses. The M protein was scanned, and demonstrated a shape of sharp high peak with a narrow bottom. M protein was detected in 64 cases by urine protein electrophoresis.(3) As to the M positions of immunofixation electrophoresis, in gamma band most are type IgG and type IgA; between beta and gamma band most are IgM;immunofixation electrophoresis is also sensitive to the uncommon IgD, IgE and double clone types.(4) The quantitative results of immunoglobulin in 120 patients with MM showed that IgG immunoglobulin increased significantly in the patients with type IgG MM,and IgM and IgA decreased gradually while IgG protein increased. In patients with type IgA, the content of IgA increased by nearly 33% compared with the normal level,while the IgG and IgM decreased. The content of IgG, IgA and IgM in light chain type patients decreased to different degrees. The contents of serum total protein and M protein in type IgD patients were lower than in type IgG and type IgA patients.(5) 7 out of the 120 patients were detected with uncommon types—IgD, IgE and double clone types. IgD, IgE, and double clone of MM patients are uncommon in clinical treatment. In laboratory tests, the IgD, IgE and the double clone types can be identified accurately by immunofixation electrophoresis.Conclusions(1) Immunofixation electrophoresis is an important method to diagnose the uncommon types of MM, and is also a sensitive method to differentiate MM from other plasma cell tumors.(2) Immunofixation electrophoresis provides a more efficient way to type MM immunoglobulin.