多发性骨髓瘤的免疫表型分析及预后价值的研究

目的 探讨初诊多发性骨髓瘤(multiple myeloma,MM)患者瘤细胞的免疫表型特征及其预后价值。 方法 应用流式细胞术,分析49例初诊MM患者瘤细胞的免疫表型,并搜集与患者预后相关的临床资料,进行统计分析。 结果 1)所有研究对象均可检测到骨髓瘤细胞,其表达CD45、CD38、CD138、CD19、CD56的阳性率依次为:8.16%、100%、89.80%、6.12%、42.86%;2)分析抗原表达与瘤细胞比例、β₂-MG、Hb、Alb、Ca等临床指标的关系,发现CD45阴性患者的β₂-MG水平高于CD45阳性患者(P＜0.05),CD19阴性患者的Hb和Alb水平低于CD19阳性患者(P＜0.05),CD56阴性患者的骨髓瘤细胞比例高于CD56阳性患者(P＜0.05),而CD138的表达与上述临床指标的水平无明显关系。 结论 多发性骨髓瘤免疫分型能有效地协助临床诊断,且CD45、CD19和CD56的缺失可能导致预后不良,对MM患者的治疗和预后评估具有重要价值。

Immunophenotype of multiple myeloma and its prognosis value

Objective To explore the immunophenotype characteristics of myeloma cells in newly diagnosed patients with multiple myeloma (MM) and its prognosis value. Methods Multiparameter flow cytometry was used to detect the immunophenotypes of myeloma cells in 49 newly diagnosed MM patients. The clinical data about the patients’ prognosis were collected and statistically analyzed. Results Myeloma cells were detected in all the patients, and the positive rates of CD45, CD38, CD138, CD19 and CD56 were 8.16%, 100%, 89.80%, 6.12% and 42.86% respectively. The concentrations of serum β₂-microglobulin (β₂-MG) in the CD45-negative patients were higher than those in CD45-positive patients (P<0.05). The levels of hemoglobin (Hb) and albumin (ALB) in CD19-negative patients were lower than those in CD19-positive patients (P<0.05). The proportion of myeloma cells in bone marrow of CD56-negative patients was higher than that of CD56-positive patients (P<0.05). However,no significant correlation was observed between the expression of CD138 and the proportion of myeloma cells, serum β₂-MG, Alb, Hb and calcium. Conclusions Determination of the immunophenotype of multiple myeloma is conducive to its clinical diagnosis. CD45, CD19 and CD56 deficiencies may induce poor prognosis. Immunophenotype determination is of great significance in guiding therapy and predicting prognosis of multiple myeloma.