Value of serum fructosamine detection in diagnosis of IgA type multiple myeloma

ZHANG Jingyu; FAN Hong; CHEN Lixin; WANG Jun

doi:10.3969/j.issn.1002-266X.2017.21.007

Abstract：Objective To investigate the value of serum fructosamine (FMN) detection in the early diagnosis of IgA type multiple myeloma (MM). Methods Seventy-seven IgA type MM patients (IgA type group), 82 IgG type MM patients (IgG type group), 7 IgM type MM patients (IgM type group), and 50 autoimmune disease patients (AID group) with serum IgA>5.0 g/L were selected. The diabetic patients were excluded from the selected cases. The levels of serum FMN were analyzed by nitro-blue-tetrazolium colorimetric method. Pearson′s linear correlation analysis was used to analyze the relationship of serum FMN with the total protein (TP), albumin (ALB), globulin (GLB), and IgA. According to the staging criterion of Durie and Salmon (DS), 77 IgA type MM patients were classified into 28 cases of stageⅠ, 24 cases of stage Ⅱ, and 25 cases of stage Ⅲ. The difference of FMN was compared in different groups and different stagings. The diagnostic value of FMN in IgA type MM was evaluated by the receiver operating characteristic (ROC) curve. Results The level of FMN in IgA type group was higher than those in the other three groups (all P<0.05). The levels of serum FMN of stage Ⅲ in IgA type MM patients were higher than those of stage Ⅱ, those of stage Ⅱwere higher than those of stageⅠ, and those of all stages were higher than those of AID group (all P<0.05). The levels of serum FMN in IgA type group were positively correlated with TP, GLB and IgA (r=0.805, 0.823, and 0.836, respectively; all P<0.05), and were negatively correlated with Alb (r=-0.732, P<0.05). The levels of serum FMN in AID group were not correlated with IgA (r=0.162, P>0.05). According to ROC analysis, the area under the curve of serum FMN for detection of IgA type MM was 0.981, and the accuracy was the highest for the cut-off value of 3.1 mmol/L. Conclusion In addition to the influence of diabetes and sample factors, the accuracy of serum FMN is high in early diagnosis of IgA type MM.