24例多发性骨髓瘤患者T辅助细胞亚群的检测及遗传学分析  

Study on T helper cells and molecular cytogenetic abnormalities in multiple myeloma of 24 patients

作　　者：曾美秀[1] 谢晓宝[1] 王志林[1] 邱国强[1] 曹祥山[1] 邹昭玲[1] 

机构地区：[1]苏州大学附属第三医院血液科,江苏常州213003

出　　处：《临床血液学杂志》2010年第4期394-397,共4页Journal of Clinical Hematology

摘　　要：目的:分析多发性骨髓瘤(MM)患者外周血Th1、Th2细胞数量和比例及骨髓细胞分子遗传学变化,探讨其相关关系及临床意义。方法:流式细胞术(FCM)检测分析24例MM患者外周静脉血Th1、Th2细胞的比例并采用荧光原位杂交技术(FISH)对其骨髓细胞13q14缺失、p53缺失、IgH易位重排进行检测。结果:①Ⅲ期MM患者Th1细胞比例较对照组显著降低,Ⅱ、Ⅲ期MM患者Th2细胞比例较对照组及Ⅰ期降低,Ⅲ期MM患者Th1/Th2比值较对照组、Ⅰ及Ⅱ期增高(P<0.05或P<0.01);②24例MM患者中检出9例13q14缺失,其中5例D13S319异常(20.83%),6例RB1异常(25.00%),8例IGH易位重排(33.33%),3例P53缺失(12.50%);③按FISH预后风险分组,高危组Th1、Th2细胞较标危组明显降低,Th1/Th2比值较之增高。结论:MM患者外周血Th1、Th2细胞比例降低及Th1/Th2比值增高,且在del(13q14)和(或)del(17p13)的高危组更为明显,与临床分期及预后相关。13q14缺失及IgH基因重排在MM患者中的发生率较高,与临床分期的关系有待进一步研究。Objective：To evaluate the changes of T helper cells（Th1/Th2）and molecular cytogenetic abnormalities of the patients with multiple myeloma（MM）for investigating their correlation and clinical significance.Method：Th1/Th2 in peripheral blood of 24 patients with MM were measured by the flow cytometry.The 13q14 deletion,p53 deletion and IgH gene translocation of bone marrow cells were tested by interphase fluorescence in situ hybridization.Result：①The proportion of Th1 was significantly lower in stage Ⅲ MM than that in controls.Th2 was significantly lower in stage Ⅱ and Ⅲ MM than that in controls and the stage Ⅰ.But the Th1/Th2 ratio in MM patients of stage Ⅲ was significantly higher than that in controls,stage Ⅰ and Ⅱ（P0.05 or P0.01）;② Among 24 MM patients,13q14 deletion was observed in 9 cases.Of which,D13S319 abnormalities accounted for 5 cases（20.83%）and RB1 accounted for 6 cases（25.00%）.IgH gene translocation was observed in 8 cases（33.33%）.p53 deletion was observed in 3 cases（12.50%）;③According to the risk stratification of FISH,the percentages of Th1 and Th2 in high-risk group was obviously lower than that in standard-risk group,but the Th1/Th2 ratio was obviously higher.Conclusion：MM patients had a low level of Th1 and Th2 but a high level of Th1/Th2 ratio,especially in the high-risk group with del（13q14）and/or del（17p13）,which was associated with clinical stages and prognosis.The frequency of del（13q14）and IgH gene translocation in MM are high,but their relationship with clinical stages is worth further investigating.

关 键 词：多发性骨髓瘤 流式细胞术 T淋巴细胞 辅助 原位杂交 荧光 分子遗传学 

分 类 号：R733.3[医药卫生—肿瘤]