First, the etiology and pathogenesis
Cause of multiple myeloma has not yet been fully elucidated, and genetic factors, chronic antigen stimulation, ionizing radiation, viral infection. Bone marrow stromal cells by the paracrine and autocrine tumor cells produce IL -6 is a major growth factor.
Second, the diagnostic criteria
Described the etiology of multiple myeloma diagnosis mainly based on hematology, immunology and imaging examination in three areas, and its diagnostic criteria are as follows:
1. Histological evidence of
Bone marrow plasma cells (tumor cells)> 15% or extramedullary plasmacytoma.
2. Immunology and radiographic evidence of the performance of one of the following:
in serum proteins. blood and urine monoclonal light chain. multiple osteolytic lesions.
Third, the classification
According to characteristics of M proteins, the disease is divided into 8 types:
(L) IgG type of the most common type, accounting for 50% of the '"'60%, with typical clinical manifestations of multiple myeloma.
(2) IgA-type accounts for about 20%. This type of extramedullary myeloma often seen rapid progression and poor prognosis.
(3) IgD-type accounts for about 5% of the national report '"'10%. This type is characterized by early age of onset, more common bone infiltration, bone destruction and is often accompanied by severe local or diffuse bone sclerosis, serum protein electrophoresis often does not appear ingredients.
(4) IgM-type of this type must have osteolytic 'lesions for diagnosis, the domestic rare, vulnerable to high Craftiness lag hyperlipidemia, Raynaud's phenomenon.
(5) IgE-type of this type of rare, is not yet discovered.
(6) accounts for about 12% of the light chain '"'20%. The synthesis of tumor cells only monoclonal light chain, the lack of heavy chain, so there are no components of serum protein electrophoresis, but the blood and urine immunoelectrophoresis detected a large number of monoclonal light chain. myeloma tumor cell growth the fastest, significant bone destruction, often with impaired renal function.
(7) two cloned type about 1% '"'2%. The most common type of dual-clone is combined IgM IgA, or IgG combined IgM.
Described the cause of multiple myeloma, (8) is not secreted about 1%. This type of blood and urine without protein or peptide chain subunit can be further divided into sub-shape is not secreted and two subtypes, the former the cytoplasm of tumor cells are monoclonal immunoglobulin and the latter none.