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多发性骨髓瘤（ＭＭ）由于起病隐匿，误诊率高，因此，建立减少多发性骨髓瘤误诊漏诊的简便过筛试验十分重要。ＭＭ关键的病理生理变化是骨髓瘤细胞产生大量的异常免疫球蛋白。高水平的异常免疫球蛋白导致患者血清总蛋白、球蛋白含量明显升高，异常免疫球蛋白包裹凝血因子和血小板，引起患者凝血功能障碍。据此，我们确定将临床常规化验项目肝功能试验中血清总蛋白＞９５ｇ／Ｌ、球蛋白＞５５ｇ／Ｌ、血块收缩不佳作为过筛指标，纠正了临床１２例ＭＭ的误诊，结果与骨髓细胞学检查符合率达１００％。尽管此过筛系统不适于仅占ＭＭ总数１％的非分泌型骨髓瘤和极少低水平异常免疫球蛋白血症的骨髓瘤病人，但只要过筛试验阳性，即提示ＭＭ的诊断。这一简便过筛系统值得临床推广应用。
Multiple myeloma (MM) has a high rate of misdiagnosis because of the onset of occult disease. Therefore, it is very important to establish a simple screening test to reduce missed diagnosis of multiple myeloma. The key pathophysiological changes in MM are myeloma cells that produce a large number of abnormal immunoglobulins. High levels of abnormal immune globulin lead to a significant increase in serum total protein and globulin levels. Abnormal immunoglobulins encapsulate coagulation factors and platelets, causing coagulopathy in patients. Based on this, we determined that serum total protein >95g/L, globulin >55g/L, and poor clot shrinkage were used as screening criteria in routine liver bioassay liver function tests, which corrected the clinical misdiagnosis of 12 cases of MM. Cytological coincidence rate of 100%. Although this screening system is not suitable for myeloma patients with non-secreting myeloma and rare low-level abnormal immunoglobulinemia that account for only 1% of the total number of MM, as long as the screening test is positive, it prompts the diagnosis of MM. This simple screening system is worthy of clinical application.