多发性骨髓瘤患者外周血肿瘤前体细胞克隆的研究  

Malignant clonogenic precursors in the peripheral blood of patients with multiple myeloma

作　　者：徐荣臻[1,2] 吴东[1,2] 黄金文 黄连生[1,2] 周璇 徐潍生 李翠琴 赵小英[1,2] 王世 

机构地区：[1]浙江医科大学附属第二医院血液科 [2]浙江医科大学附属邵逸夫医院血液肿瘤科

出　　处：《中华医学杂志》1998年第5期356-358,共3页National Medical Journal of China

摘　　要：目的探索多发性骨髓瘤（ＭＭ）患者循环血液中肿瘤前体细胞克隆及其生物学特征。方法采用细胞培养体系对ＭＭ患者外周血单个核细胞（ＰＢＭＮＣｓ）中可能存在的肿瘤前体细胞克隆进行扩增与促分化，同时用免疫细胞化学染色，形态学观察及扫描电镜技术对其生物学特性进行初步研究。结果１４例无浆细胞污染的ＭＭ患者新鲜ＰＢＭＮＣｓ样本以小淋巴样细胞为主。培养第３天时，可见较多增殖十分活跃成簇生长的免疫母细胞样Ｂ淋巴细胞，占有核细胞的３８％±１４％，胞浆Ｉｇ阴性，浆细胞相关抗原ＣＤ３８阳性，未见形态学典型的浆细胞。培养第６天时，培养物中则以典型的浆细胞团生长为主，占有核细胞的５８％±８％。这些浆细胞高表达ＣＤ３８抗原以及与原患者骨髓瘤细胞一致单克隆性胞浆Ｉｇ。结论ＭＭ患者ＰＢＭＮＣｓ中含有高增殖潜能的肿瘤前体细胞克隆。Objective To study the clonogenic potential of circulating malignant precursors in the peripheral blood of patients with multiple myeloma (MM). Methods A new cell culture system was used to expand putative malignant precursor clones and promote their differentiation. Meanwhile, immunocytochemical staining, Giemsa Wright staining and scanning electron microscopy were employed to reveal the growth properties and biological features of fresh and expanded malignant precursors and plasmacytes. Results Small lymphocyte like B cells, which were actively proliferative and grew in the form of clusters, were found at the third day after culture. They accounted for 38%±14%. The cells didn't express cytoplasmic immunoglobulin (CyIg) and CD38 antigen. In addition, no typical plasmacytes were observed. At the sixth day of culture, morphologically discernible plasmacytes, which grew in the form of large clumps in this culture system, were detected and represented 58%±8%. These plasmacytes strongly expressed CD38 antigen and monoclonal CyIg identical to that of the original myeloma cells. Conclusion Malignant clonogenic precursor cells, which have high proliferative potential, are present in the peripheral blood of MM cases, and could proliferate and differentiate into myeloma cells.

关 键 词：多发性骨髓瘤 肿瘤前体细胞 克隆 

分 类 号：R733.3[医药卫生—肿瘤]