多参数流式细胞术测定多发性骨髓瘤细胞免疫标记的研究

本研究探讨多发性骨髓瘤(MM)的免疫表型特征及其意义。采用多参数流式细胞术直接免疫荧光技术,CD38/SSC设门,对33例MM患者及12例浆细胞反应性增多症患者的骨髓标本进行免疫分型检测,并辅以瘤细胞的形态学检查。结果表明:形态学检查观察到瘤细胞比例为6.0%-76.0%;流式细胞术CD38/SSC设门后可见到一群CD38强阳性细胞,比例为0.99%-57.54%;多数MM细胞表型为CD38st+CD138+CD19-CD56+(78.8%),部分患者伴有CD20(12.1%)、CD33(15.2%)、CD117(30.3%)、HLA-DR(9.1%)抗原表达,其余抗原表达均为阴性;27例(81.8%)MM患者检测到cκ或cλ的单克隆限制性,其余cκ及cλ均为阴性。结论:利用CD38/SSC设门方法的流式细胞术对MM进行免疫分型,根据细胞表面抗原的异质性,可鉴别良性或恶性浆细胞,为判断预后及靶向治疗提供依据。

Immunophenotype in multiple myeloma cells detected by multiparameter flow cytometry

This study was purposed to investigate the immunophenotypic characteristics in multiple myeloma (MM) cells and their significance. Thirty three cases of MM and 12 cases of reactive plasmacytosis (as control group) were enrolled in the study. The expressions of surface antigens in MM cells were detected with flow cytometry by using direct immunofluorescent technique and gating method of CD38/SSC and were confirmed with morphologic observation of myeloma cells. The results indicated that the proportion of myeloma cells detected by morphologic examination was 6.0% - 76.0%. With CD38/SSC gating method, a cluster of CD38 bright positive cells could be detected in their scatter plot, the proportion ranged from 0.99% to 57.54%. Most phenotype of MM was 38(st+)CD138(+)CD19(-)CD56(+) (78.8%). While the expressions of CD20, CD33, CD117, HLA-DR were seen in some MM patients, the positive rates were 12.1%, 15.2%, 30.3%, 9.1%, respectively; the expression of other antigens was negative. cκ or cλ monoclonal restriction was detected in 27 cases (81.8%) of MM, both cκ and cλ in the remaining cases of MM was negative. It is concluded that detecting the immunophenotype of MM patients by flow cytometry with CD38/SSC gating method and basing on the heterogeneity of cell antigens can discriminate myeloma cells from normal plasma cells, which provides evidence for targeted therapy and prognosis evaluation.