多发性骨髓瘤免疫标志联合国际分期系统分期对临床治疗及预后判断的意义  

Significance of combined measurement of immunophenotype and international staging system in multiple myeloma

作　　者：何兰兰[1] 谢晓宝[1] 邱国强[1] 

机构地区：[1]苏州大学附属第三医院常州市第一人民医院血液科,江苏常州 213003

出　　处：《白血病．淋巴瘤》2013年第1期57-60,共4页Journal of Leukemia & Lymphoma

摘　　要：目的探讨多发性骨髓瘤（MM）瘤细胞的免疫标志特征、CD28及国际分期系统（ISS）分期在临床治疗及预后判断的意义。方法用四色流式细胞仪检测49例初诊及22例治疗组MM患者瘤细胞膜表面免疫标志的表达情况，并将患者依据ISS分期法、综合风险组分期，对疗效、生存期进行评价分析。结果随着ISS分期升高，治疗有效率降低『I、Ⅱ、Ⅲ期有效率分别为83．3％（4／6）、38．5％（5／13）、36．5％（19／52）]（X2=4．235，P=0．04），总生存期及无进展生存期缩短，组间比较差异有统计学意义（均P〈0．05）。CD。的异常表达率在初诊及治疗组患者之间差异无统计学意义[27（55．1％）、14（63．4％）】（P〉0．05），CD28组患者较cD五组的生存期缩短，差异有统计学意义（P=0．040）。综合风险组中，高危组较低危组治疗有效率降低，差异有统计学意义（X2=5．620，P=0．018），总生存期及无进展生存期缩短，差异有统计学意义（P〈0．01）。结论MM患者高ISS分期、CD28表达者、高危组预后较差。Objective To investigate the immunophenotype characteristics,the clinical significance of CD2s and International staging system in multiple myeloma （MM）. Methods BM aspirate samples from 49 newly diagnosed MM patients and 22 patients after treatment were assessed using 4 color flow cytometric analyses. These MM patients were classified according to International staging system and the consolidated risk staging system, and the survival rates and treatment efficiency of 2 staging system were compared. Results The higher stage, according to the international staging system, the lower treatment efficiency [the efficacy rates of I, II,Ⅲ stage were 83.3 % （4/6）, 38.5 % （5/13）, 38.5 % （5/13）, 36.5 % （19/52）] （X2 = 4.235, P = 0.04）, and the survival and progression-free survival time of high-risk group were significantly shortened （P 〈 0.05）. The rate of CD28 abnormal expression was no significant different between the initial and the treatment group [27 （55.1%）, 14 （63.4 %）], also similar in the impact of survival and progression-free survival time （P 〉 0.05）. According to the consolidated risk staging system,the treatment efficiency, the survival and progression-free survival time of high-risk group were significantly shortened than the low ones （P = 0.040）. Conclusions The patients with higher ISS stage, abnormal expression of CD28, and high-risk group have poor prognosis.

关 键 词：多发性骨髓瘤 免疫表记 临床分期 生存期 预后 

分 类 号：R733.3[医药卫生—肿瘤]