多发性骨髓瘤浆细胞标记指数检测的临床意义研究

目的探讨多发性骨髓瘤（MM）中浆细胞标记指数（PCLI）检测的临床意义及与年龄、疾病分期、骨髓浆细胞数、β2-微球蛋白（β2-MG）、白蛋白、乳酸脱氢酶（LDH）、血肌酐、生存期及13q14缺失[del（13q14）]等的相关性。方法应用免疫荧光玻片计数法检测42例初诊MM患者PCLI,并应用间期荧光原位杂交（I-FISH）技术,用位于13q14的序列特异性DNA探针D13S319,检测患者del（13q14）异常情况。结果 42例初诊MM患者中,PCLI阳性18例（42.9%）,其中del（13q14）阳性14例,阴性4例;PCLI阴性24例（57.1%）,其中del（13q14）阳性12例,阴性12例,PCLI高表达患者具有更高的del（13q14）发生率（P〈0.01）。PCLI阳性与年龄、疾病分期、骨髓浆细胞数、β2-MG、白蛋白、LDH、肌酐等无相关性（P值均〉0.05）,与疾病无进展生存期（PFS）短有关（P〈0.05）。结论 PCLI是判断MM患者预后的重要指标,阳性患者,疾病进展快,生存期短。PCLI阳性者del（13q14）发生率高。

Investigation of the clinical significance of plasma cell labeling index for multiple myeloma

Objective To investigate the clinical significance of plasma cell labeling index(PCLI) for multiple myeloma(MM),and to investigate the correlation of PCLI with the age,disease stage,bone marrow plasma cell percentage,β2 microglobulin(β2-MG),serum albumin,lactic dehydrogenase(LDH),serum creatinine,disease progression-free survival and chromosome 13q14 deletion [del(13q14)].Methods Forty-two previously untreated MM patients received PCLI measurement through using a slide-based immunofluorescence method.Interphase fluorescence in situ hybridization(I-FISH) was applied to detect del(13q14) with the specific DNA D13S319 probe in sorted MM cells.Results Among 42 patients with MM,positive PCLI was observed in 18(42.9%) cases,and del(13q14) was observed in 25(58.5%) cases,and among which,both were positive in 12 cases.There was no correlation among a high PCLI with the age,disease stage,bone marrow plasma cell percentage,serum β2-MG,albumin,LDH and serum creatinine(P>0.05).Those patients with a high PCLI significantly predicted a high incidence of del(13q14)(P=0.006) and had a shorter progression-free survival time(P=0.023).Conclusions PCLI is also a powerful prognostic parameter for MM,and correlates with del(13q14).