关键词: N-糖谱, 轻链型多发性骨髓瘤, DNA测序仪辅助的荧光糖电泳

Abstract:

Objective To investigate the characteristic and clinical significance of serum N-glycan profile in light chain multiple myeloma(LCMM). Methods A retrospective analysis of serum N-glycan profile was performed in LCMM patients, IgG multiple myeloma(MM) patients and healthy controls with matched sex amd age by DNA sequence-assisted, fluorophore-assisted carbohydrate electrophoresis (DSA-FACE). Results Peak3 (single agalacto,core-alpha-1,6-fucosylated biantennary, NG1A2F) and Peak6(bigalacto, core-alpha-1,6-fucosylated biantennary, NA2F) in LCMM patients were significantly lower than those in healthy controls, while Peak5 (bigalacto, biantennary, NA2) was significantly higher. Using Peak 3 to verify the diagnosis efficiency, the area under the receiver operating characteristic (ROC) curve of Peak3 was 0.943. The optimum diagnosis cut-off value was 5.15% with sensitivity 88.1% and specificity 90.5%. The decrease of Peak3 and Peak6 and the increase of Peak5 were found in LCMM patients, as compared with IgG MM patients. Using Peak3 to verify the differential diagnosis efficiency, the area under the ROC curve of Peak3 was 0.895. The optimum differential diagnosis cut-off value was 6.77% with sensitivity 100.0% and specificity 78.6%. The changes of Peak3, contrary to Peak5, were positively correlated with IgG, total protein, M-spike and serum light chain ratio, and were negatively correlated with albumin, hemoglobin and platelet in the correlation analysis between serum N-glycan profile and routine laboratory parameters in the 3 groups, and the changes of Peak 6 were negatively correlated with urea and creatinine. Conclusions The characteristic change has taken place in the serum N-glycan profile of LCMM patients, especially Peak3, which is closely bound on the symptoms of hypoglobulinemia, kidney function injury and the progression of disease. Meanwhile, Peak3 may become a new biomarker for diagnosing and differentially diagnosing LCMM. During the prognosis evaluation and monitoring of LCMM, the determination of N-glycan profile avoids the hurt of drawing bone marrow and eliminates the detecting errors caused by polymers of light chain and kidney malfunction on the determination of serum and urine light chains.

Key words: N-glycan profile, Light chain multiple myeloma, DNA sequence-assisted, fluorophore-assisted carbohydrate electrophoresis