流式细胞术在多发性骨髓瘤诊断中的应用

目的探讨流式细胞术免疫分型在多发性骨髓瘤（MM）诊断中的价值。方法应用多参数流式细胞仪检测35例MM和10例继发性单克隆免疫球蛋白血症骨髓细胞免疫表型。结果 35例MM患者表达CD38、CD138强阳性,平均荧光强度（MFI）分别为695.2±120.69、56.23±436.2。CD45阴性或弱阳性。33例MM患者CD19阴性。32例MM患者表达CD56强阳性,MFI为779.9±241.0。10例继发性单克隆免疫球蛋白血症患者表达CD38、CD138强阳性,MFI分别为621.3±82.8、549.6±132.7。CD45表达均阳性。8例患者CD19阳性。CD56均阴性,MFI为24.61±13.1。MM患者CD44表达荧光强度明显高于继发性单克隆免疫球蛋白血症（P〈0.01）。结论应用多参数流式细胞仪检测细胞表面CD38、CD138、CD19、CD56、CD45、CD44抗原表达情况,可方便区分骨髓瘤和良性浆细胞,是MM的重要诊断依据。

Diagnostic value of flow cytometry immunophenotype for Multiple Myeloma

Objective To explore the effect of immunophenotype for diagnoses of patients with multiple myeloma（MM）.Methods CD45/side scatter（ssc） gating four-color immunofluorescence multiparameter flow cytometry（MP-FCM） was used to test immunophenotype of 35 MM patients and 10 patients with secondary monoclonal gammopathy.Results Myeloma cells displayed both CD138 and CD38 strong positive expression,mean fluorescence intensity（MFI） were 695.2±120.6 and 956.23±436.2.CD56 was strong positive in 91.43%（32/35）cases,the MFI was 779.9±241.0.While CD19 was negative in 33 cases and CD45 was all negative/low positive.The results of patients with secondary monoclonal gammopathy show that CD38 and CD138 were strong positive,the MFI were 621.3±82.8 and 549.6±132.7.CD56 was negative in control group patients,the MFI only was 24.61±13.1.while CD19 was positive in 8 patients and CD45 was all positive.Expressed fluorescence Strength of CD44,myeloma cells was significant strong than secondary monoclonal gammopathy cells.Conclusion MP-FCM is an important diagnostic method for MM and testing CD38,CD138,CD19,CD56,CD45 and CD44 can help distinguish myeloma cells from plasma cells.