多发性骨髓瘤患者恶性克隆及其前体细胞检测

 为了探讨多发性骨髓瘤(MM)克隆起源, 病情判断, 以克隆性免疫球蛋白重链(IgH)基因重排为骨髓瘤基因标志, 采用聚合酶链反应(PCR)技术分析MM患者骨髓和外周血克隆性IgH基因重排。42例MM的骨髓标本34例阳性, 阳性率80.95%, 阳性率与临床分期及免疫分型不相关(P＞0.05)。10例反应性浆细胞增多症(RP)及12例正常人骨髓均阴性。24例形态学检查正常的MM外周血16例阳性, 阳性率66.67%, Ⅱ、Ⅲ期患者阳性率明显高于Ⅰ期(P＞0.025), Ⅱ、Ⅲ期之间无差异(P＞0.05)。与免疫分型不相关(P＞0.05)。外周血与骨髓均阳性患者, 克隆性IgH基因重排带位于同一电泳位置, 不同患者重排带呈多态性。研究结果表明：克隆性IgH基因重排可作为骨髓瘤克隆基因标志, MM外周血存在克隆性B细胞, 且与骨髓瘤细胞起源于同一克隆。 MM骨髓和外周血克隆性IgH基因重排检测对MM诊断, 骨髓瘤细胞克隆起源研究, 病情判断均有一定价值。

Detection of myeloma cells and their precursors in patients with multiple myeloma

Investigating clonal origin, assessment of severity of disease of multiple myeloma (MM) METHOD:Using Clonal immunogobulin heavy chain (IgH) gene rearrangement as a gene marker of myeloma 42 bone merrow specimens from MM. Patients were detected the ceonal IgH rearrengement by polymease chaim reaction (PCR). 34 of 42 marrow specimens showed clonal IgH gene rearrangement which was 80.95% positive percentage. However, the positine shpeimens did not correlate with the clinical stage and immune classification (P＞0.05 ). There was no clonal IgH gene rearrangement detected in 10 patients with reactive plasmacytosis (RP) and 12 normal sntjects. 16(66.67%) of the 24 peripheral blood specimens was detected clonal IgH gene rearrangement. The incidence of clonal IgH gene rearrangement in peripheral blood of MM patients with stage Ⅱ and Ⅲ was much higher than that with stage Ⅰ (P＜0.025), but did not correlete with immune classification (P＞0. 05). The clonal IgH gene rearrangement detected in peripheral blood was identical with that in bone marrow within the same patient,but there was difference among patients. Thus detection of clonal IgH gene rearrangement in MM may provide important information for study of clonal origin ofmyeloma and assessment of severity of disease.