| Objective:In demades,Multiple myeloma has a rapid development the diagnosis in treatment and prognosis among all the malignant tumors in the field,It is second only to lymphoma in hematological malignancies and is still not able to be cured[1].The progress of the treatment of MM is mainly due to the improvement of the level of diagnosis,especially in the multilevel aspects of serum,cells,molecules and genes.Serum free light chains were the most significant item in serological diagnosis for the detection of MM.This method greatly make up with previous clinical manifestations,percentage of plasma cells in bone marrow and immunofixation electrophoresis,which is not sensitive,quantitative and easily missed defects.We used sFLCs test combined with IFE to screen,evaluate the prognosis and evaluate the efficacy of multiple myeloma in order to further evaluate the value of serum free light chain detection in the clinical management of multiple myeloma.Methods:From January 1,2012 to January 1,2018,99 hospitalized patients with primary multiple myeloma in Department of Hematology of Jiangsu Subei People’s Hospital were selected,and 50 healthy people were set up as the control group.The patients of MM were screened by sFLCs detection combined with IFE.Then 87 cases of MM patients with complete data were followed up for an average of 30.2 months,and the results of sFLCs detection at the first diagnosis were combined with the R-ISS staging system to determine the prognosis of the disease.In addition,sFLCs test combined with IFE was used to evaluate the efficacy of 40 patients treated with different regimen,including CTD regimen and PAD regien,for four courses of treatment.Results:1.SFLCs and IFE were used in 99 patients with first diagnosis of MM and 50 cases of health examination.Then,the results of different detection methods were checked by SPSS 22.The results showed that there was a statistical difference between sFLCs and IFE.SFLCs detection is more sensitive than IFE,and the combination of sFLCs and IFE detection has higher sensitivity and specificity than any single detection method.2.The survival curves of 87 MM patients were analyzed by sFLCs combined with R-ISS staging system.The results showed that the higher the serum free light chain rate and the later the stage,the worse the prognosis.3.In addition,among 40 patients with different treatment regimens(including CTD and PAD)and over four courses of MM patients were evaluated,paired samples t test indicated that p<0.01 by EXCEL,the difference was statistically significant sFLCs before and after treatment of different treatment regimens and found that the curative effect is better than that of rank sum test CTD PAD treatment regimen.Conclusion:sFLCs detection combined with IFE can screen out MM patients,determine the prognosis of newly diagnosed MM patients,optimize the treatment options,and test the therapeutic efficacy.Therefore,sFLCs detection combined with IFE is of great significance in the clinical management of MM patients(including early diagnosis,prognostic evaluation,and evaluation of efficacy). |
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