Vnitr Lek 2006, 52(3):232-240

Comparison of serum levels of selected biological parameters in monoclonal gammopathy of undetermined significance and multiple myeloma

V. Ščudla^1,*, M. Budíková², T. Pika¹, J. Minařík¹, M. Zemanová¹, J. Bačovský¹, V. Heincová³, Česká myelomová skupina

¹ III. interní klinika Lékařské fakulty UP a FN, Olomouc, přednosta prof. MUDr. Vlastimil Ščudla, CSc.

² Klinika nukleární medicíny Lékařské fakulty UP a FN, Olomouc, přednosta doc. MUDr. Miroslav Mysliveček, CSc.

³ Hematologické a transfuzní oddělení Slezské nemocnice, Opava, přednostka prim. MUDr. Vladimíra Heincová

Purpose of study:
The study focuses on evaluation of differences in serum levels of selected biological indicators in monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM), primarily from the viewpoint of potential asset to clinical practice.
Patients and methodology:
The analyse set of 96 patients consisted of 30 individuals with MGUS and 66 patients with MM examined in the context of the disease diagnosis before therapy commencement. Serum levels of the assessed parameters were examined with the help of radio-enzymatic method (thymidinkinase), radioimmunoanalysis (β₂-micro-globulin, ICTP, PINP), enzymoimmunoessay method (sIL-6R, sVCAM-1, sICAM-1, sOPG and sRANKL) and the technique of quantitative sandwich enzymatic immunoessay (sHGF, sVEGF, bFGF, syndecan-1/CD₁₃₈ and sFas). Statistical examination was performed by Pearson and Fischer test, χ²-test, or nonparametric U-test pursuant to Mann-Whitney (p < 0.05).

Results:
Statistically significant differences were found between MGUS and MM in the case of serum level comparisons of sIL-6R (p = 0.02), ICTP (p = 0.001), sHGF (p = 0.001) and syndecan-1/sCD₁₃₈ (p = 0.001), while no statistically significant differences were present in the case of sVCAM-1, sICAM-1, PINP, sOPG, sVEGF and sFas. During the analysis of frequency of occurrence of abnormal values in the MM and MGUS groups, significant differences were found not only in the case of standard parameters, such as β₂-microglobulin, thymidinkinase, creatinin and albumin, but also in the case of sIL-6R, ICTP, sHGF and syndecan-1, but not in comparisons of the levels of sVCAM-1, sICAM-1, PINP, sOPG, sVEGF and sFas. Attempts at examination of serum levels of sRANKL and soluble form of bFGF failed as too low values were measured.

Conclusion:
The analysis of behaviour of the 10 parameters, mostly intimately related to biological properties of clonal plasmatic cells or to changes of microclimate of bone marrow, effectively contributed to distinction between MGUS and MM only in the case of serum levels of sIL-6R, ICTP, sHGF and syndecan-l (sCD₁₃₈), i.e. indicators with demonstrable relevance for MM prognosis assessment.

Keywords: multiple myeloma; monoclonal gammopathy of undetermined significance; angiogennic cytokines; indicators of bone turnover; syndecan-1; sFas

Received: December 14, 2005; Accepted: December 29, 2005; Published: March 1, 2006  Show citation