多发性骨髓瘤患者骨髓中CD56和CD117水平表达对评估疾病预后的价值

目的　探讨多发性骨髓瘤(multiple myeloma，MM)患者CD56和CD117表达在疾病预后评估中的价值。方法　选取2019年12月～2020年12月首都医科大学附属北京潞河医院32例初诊MM患者，根据骨髓中CD56和CD117表达，分为CD56+CD117+，CD56+CD117-，CD56-CD117+和CD56-CD117-四组，分别检测各组骨髓瘤细胞数、M蛋白含量和细胞遗传学结果；采用单因素方差分析CD56，CD117表达与骨髓瘤细胞数量、细胞遗传学结果在疾病预后判断中的意义。结果　CD56和CD117阳性率分别为62.5%和33.3%。CD56-CD117-组骨髓瘤细胞为36.6%±23.9%明显高于其他三组（5.5%±2.8%，12.1%±7.3%，24.4%±5.9%），差异有统计学意义（F=4.061，P=0.022）。TP53阳性率在CD56-组（25%）显著高于CD56+组（14.3%），差异有统计学意义（χ2=3.854，P=0.04）。CD117+组与CD117-组相比，TP53，1q21+，IGH融合阳性率比较差异无统计学意义（χ2=0.323~2.677，均P>0.05）。TP53和CCDN1/IGH阳性率在CD56-CD117-组（33.3%和50.0%）明显高于CD56+CD117+组（20.0%和40.0%）和CD56+CD117-组（11.1%和33.3%）差异均有统计学意义（χ2=6.036~14.579，均P<0.05）。结论　CD56-和CD117-MM患者肿瘤负荷较高，并且出现TP53缺失、CCND1/IGH融合和复杂核型等细胞遗传学异常风险较高，预后较差。

Significance of the Expression of CD56 and CD117 in Evaluating the Prognosis of Patients with Multiple Myeloma

Objective　To investigate the expression of CD56 and CD117 in patients with multiple myeloma (MM), and evaluate its value in clinical prognosis judgment. Methods　A total of 32 cases of newly diagnosed multiple myeloma in the Department of Hematology, Beijing Luhe Hospital of Capital Medical University from December 2019 to December 2020 were enrolled this study. According to the expression of CD56 and CD117, they were divided into 4 groups: CD56+CD117+，CD56+CD117-，CD56-CD117+ and CD56-CD117-. The number of plasma cells and M protein type and content were detected. Single factor variance was used to analyze the relationship between CD56, CD117, myeloma cells, and cytogenetics in disease diagnosis and prognosis. Results　 The positive of CD56 and CD117 was 62.5% and 33.3%. Myeloma cells in CD56-CD117-group 36.6%±23.9% was much higher than the other three group（5.5%±2.8%，12.1%±7.3%，24.4%±5.9%）, the difference statistically significant(F=4.061，P=0.022). Comparison with CD56- patients, the incidence of TP53 was significantly lower in CD56+ patients（25% vs14.3%）, the difference statistically significant（χ2=3.854，P=0.04）. Compared with CD117-, the positive rate of TP53, 1q21+ and IGH translocation was not significantly different (χ2=0.323~2.677, all P>0.05). The positive rates of TP53 and CCND1/IGH in the CD56-CD117- group （33.3%，50%）were significantly higher than those in the CD56+CD117+ （20.0%，40%）and CD56+CD117- groups（11.1%，33.3%）, the difference statistically significant (χ2=6.036~14.579, all P<0.05). Conclusion　CD56- and CD117- patients had higher tumor burden and much higher risk of cytogenetic abnormalities such as TP53, CCND1/IGH, complex karyotype, and the worse prognosis.