Liprotheine tsa Bence-Jones ke likaroloana tse nyenyane tsa li-antibodies tse ka fumanoang ho sebelisa teko ea metso, haholo-holo ho hlahloba le ho hlokomela bakuli ba nang le multipleeloma e mengata, mofuta oa kankere ea mali.
Myeloma e ngata
Myeloma e ngata ke kankere e hlahisang mofuta oa sele e tšoeu ea mali e bitsoang cell cell. Lisele tsa 'mele ke lisele tse etsang hore li-antibodies li u thuse ho loantša tšoaetso.
Bakeng sa lisele tsa mali tse hlahisoang ke li-plasma tse hlahisang batho, e mong a ka bolela hore mefuta e fapaneng ke khoebo ea bona. Ba etsa mefuta eohle ea mefuta e meng ea liprotheine.
Manyeloma e mengata ke e 'ngoe ea mafu a' maloa a ka hlahisang "selefono e le 'ngoe ea lisele tsa mali ea mali." Nahana ka sekhukhu se le seng feela joalokaha ho hong ho amanang le letšoele la lisele tse tšoanang. Letšoele lena ha le fapane. Hangata lisele tsa sele e le 'ngoe li etsa li-proteine tse tšoanang le likokoana-hloko.
M-liprotheine
Ha ho buuoa ka liprotheine tsa Bence-Jones, mantsoe a mangata a mangata a atisa ho sebelisoa, a kang myeloma protheine, M-proteins, paraproteins, li-chain tsa mahala tsa immunoglobulin le M-spike. Mantsoe ana kaofela a tšoana, empa ha a hlile ha a fetohe.
'M' ka protheine ea M e emela monoclonal, ho bolelang hore pokello ea liprotheine e tsoa mothong e le 'ngoe ea lisele tse hlahisang motho. Lisele tsena kaofela li hlahisa li-antibodies tse tšoanang kapa likarolo tsa antibody.
Liketane tse khanyang
Litsebi tsa bo-rasaense li re li-immunoglobulin-li bolela hore li thusa ho loantša mafu le globulin, ho bolelang hore ke liprotheine.
Hangata li-immunoglobulin tsena li khōlō haholo, empa li na le lihlopha tse nyenyane tse kopantsoeng. Li-antibodies ha e le hantle li na le liprotheine tse 'maloa tse nyenyane, tse bitsoang liketane tse boima le liketane tse khanyang.
Setšoantšong se ka holimo, o ka bona anti-antibody kapa immunoglobulin e ka holimo, empa setho se seng le se seng se entsoe ka likaroloana tse seng kae.
Likarolo tse seputsoa ke "liketane tse boima" 'me likarolo tsa khauta ke "liketane tse bobebe." Setšoantšong sena, liketane tsa khauta li ka fetoha liprotheine tsa Bence-Jones ho motho ea nang le myeloma e mengata kapa boemo bo bong.
Li-proteine tsa Bence-Jones ehlile e le pokello e khethehileng ea likaroloana tse nyane tsa antibody (lihlopha tsa leseli) . Boteng ba liketane tse khanyang ka bongata bo joalo ka metsing ha bo tloaelehe. Hangata, liprotheine tse nyenyane feela tse nang le leseli li ka fumanoa ka hara moroto. Likhoele tse khanyang ka metsing li ka 'na tsa hlaha ka mabaka a mangata a fapaneng, leha ho le joalo, eseng kaofela ha tsona ke kankere.
Monoclonal Light Chains
Hona joale, tabeng ea liprotheine tsa Bence-Jones, ke habohlokoa ho hopola hore lithane tsena tse khanyang hase feela mefuta ea khale ea khanya - ke lichelete tse khanyang tsa monoclonal .
Joale liprotheine tsa Bence-Jones, li ...
- Monoclonal (e tsoa sehlopheng se seng sa lisele)
- Likhoele tsa lisele tsa monoclonal (likopi tse ngata tsa karolo e tšoanang, e nyenyane ea likokoana-hloko)
- E fumanoe ka mokokotlong mme e kopantsoe le maemo a fapa-fapaneng, ho kopanyelletsa le myeloma e mengata.
Maemo
Liprotheine tsa Bence-Jones ke mofuta o khethehileng oa li-proteine, 'me li nyenyane hoo li ka fetolang mokhoa oa' mele oa ho hloekisa, liphio. Sena se bolela hore, ha liketane tsena tse khanyang li hlaha ka bongata, li tla fetela ho tloha mali a hao ho ea ka morong oa hau.
Ho na le maemo a 'maloa ao liprotheine tsa Bence Jones li ka fumanoang ka har'a motsoako oa motho, ho kenyelletsa tse latelang:
- Manyeloma e mengata - Myeloma e ngata ke kankere ea mali eo ho eona ho nang le ho feteletsoa ha lisele tsa plasma - liseleng tse hlahisoang ho tloha ho B lymphocytes lefung la bone. Lisele tsa plasma ke lisele tse etsang hore li-antibodies li re sireletse likokoana-hloko tse itseng le libaktheria. Pakeng tsa 50 le 80% ea batho ba nang le myeloma ba tla ba le liteko tsa mochini o motle bakeng sa liprotheine tsena.
- Macroglobulinemia ea Waldenström - Macroglobulinemia ea Waldenstrom ke kankere e sa tloaelehang e hlahang lisele tsa B (mofuta oa sele e tšoeu ea mali). Lisele tsa B li fetela ka mokhoa oa ho fetoha lisele tsa plasma tse hlahisang batho. Lefung lena, kankere e hlaha ka seleng ea B, pele ho ntlha eo e fetohang sele ea plasma; ka hona, Macroglobulinemia ea Waldenström e fapane le myeloma e mengata, empa maemo a mabeli ke litsela tse ling tse tšoanang, 'me ka bobeli li ka hlahisa liprotheine tsa Bence-Jones.
- MGUS - MGUS e emela monoclonal gammopathy ea bohlokoa bo sa boleloang. Lefu lena le ka 'na la e-ba selelekela sa myeloma e mengata' me e kenyelletsa keketseho ea lisele tsa plasma, empa ha ho le matšoao a mang a amanang le myeloma e mengata.
Bohlokoa
Liprotheine tsa Bence-Jones li teng ho bakuli ba babeli ho ba bararo ba nang le myeloma e mengata. Myeloma e ngata ke kankere ea mali e kenyelletsang tlhahiso e feteletseng ea lisele tsa mali. Feela joalokaha kankere ea matšoafo e ne e tla ba le lisele tse ngata tse sa tloaelehang tsa kankere, myeloma e kenyelletsa lisele tse ngata tsa mali.
Lisele tsa 'mele ke lisele tse etsang hore li-antibodies li re thuse ho loantša maloetse. Leha ho le joalo, lisele tse nang le kankere ea mali tse nang le kankere, ha li etse li-antibodies tse thusang ho loantša maloetse, empa ho e-na le hoo, lisele tse ngata tsa mali li etsa hore ho be le li-antibodies tse feteletseng tse tšoanang.
Ho fetela ha li-immunoglobulin 'meleng ho ka ba bothata ho tsoa lihlopheng tse sa tšoaneng, tse ling tsa tsona ke lefu la liphio . Ka tlhaho, li-antibodies li kholo haholo hoo li ke keng tsa etsoa ka har'a li-tubong liphio. Liprotheine tsa Bence-Jones li nyenyane hoo li ka kenang lihlopha tse hlahisang liphio. Liphio, liprotheine tsena li ka haha le ho baka mathata a liphio. Mefuta e meng ea liprotheine e ka 'na ea lematsa liphio ka tsela ena ho feta ba bang. Ho boetse ho na le liphello tse ling tsa liketane tse khanyang tse ka etsang likarolo tse fapaneng tsa 'mele.
Haeba u fumanoe u e-na le lefu le hlahisang liprotheine tse ngata tsa leseli, ngaka ea hau e ka 'na ea u hlahloba ka mathata a amanang le eona. E 'ngoe ea lintho tse ka hlahelang ka liketane tse khanyang li bitsoa amyloid light chain chain (amyloid light chain chain), moo lihlopha tsa leseli li tlang hammoho ebe li etsa li-deposit tsa ntho e bitsoang amyloid, e ka bakang tšenyo likarolong tse sa tšoaneng.
Tlhahlobo ea Urine
Teko ea liprotheine tsa Bence-Jones e akarelletsa ho bokella motsoako oa hao bakeng sa lihora tse 24 ho hlahloba bopaki ba liprotheine. Liprotheine tsa Bence-Jones li bitsoa Henry Bence Jones, setsebi sa mafu a lik'hemik'hale se ileng sa qala ho sibolla lintho tse sa tloaelehang tsa lisele tsena tsa urine bohareng ba bo-1800. Ho na le mefuta e 'meli ea liketane tse khanyang tse bitsoang kappa le lambda. Mofuta o tobileng oa ketane e khanyang e ka ba le moelelo oa bongaka.
Lentsoe le Tsoang ho
Haeba u sa tsoa fumanoa, fumana nako ea ho ithuta ka lefu la hao mme u botse lipotso. Fumana thuso bakeng sa metsoalle le baratuoa ba hau. 'Me u itšetlehe ka tšepo. Phekolo ea kankere ea mali e ntlafalitsoe haholo lilemong tsa morao tjena, 'me mekhoa e mecha ea phekolo e ntse e le litekong tsa meriana.
> Mehloli:
> Basile U, Gulli F, Torti E, et al. Tlhahlobo ea mokhoa oa ho hlahloba mokhoa oa Bence Jones protheine analysis. Clin Chem Lab Med. 2016; 54 (11): e331-e333.
> Cook L, Macdonald DHC. Tsamaiso ea paraproteinaemia. Medical Journal ea morao-rao . 2007; 83 (978): 217-223.
> Kyle, R., Larson, D., Therneau, T. le al. Lenane la khanya le fokolang le fokolang multiple myeloma (idiopathic Bence Jones proteinuria): sebopeho sa lihlopha. Lancet Hematology . 2014. 1 (1): e28-36.