多发性骨髓瘤残留监测的方法学进展  

Advances of multiple myeloma detection in multiple myeloma

作　　者：胡建娥[1] 孙秋艳[2] 李良琼[1] 唐燕 HU Jian-e;SUN Qiu-yan;LI Liang-qiong;TANG Yan(Department of Clinical Laboratory,Chongqing Three George Hospital,Chongqing 404000,CHINA;Department of Clinical Pharmacy,Chongqing Three George Hospital,Chongqing 404000,CHINA)

机构地区：[1]重庆三峡中心医院检验科,重庆404000 [2]重庆三峡中心医院药学部,重庆404000

出　　处：《海南医学》2020年第1期118-122,共5页Hainan Medical Journal

摘　　要：多发性骨髓瘤是发生于骨髓的多灶性浆细胞肿瘤,它与血清和/或尿M-蛋白有关。大多数病例有广泛的骨髓累及。临床表现变化大,从无症状到侵袭,其临床表现主要是由于异常的免疫球蛋白链沉积所致。近年来,多发性骨髓瘤(MM)的治疗方法发生了很大的变化,大大提高了多发性骨髓瘤的缓解率,但是其复发率也很高,表明现有的检测方法不能检测出一些微量的持续性异常。传统的外周血、骨髓细胞形态学、影像学检查等检测手段仍很重要,但是,Allele-specific聚合酶链反应、下一代测序和多色流式细胞术使微小残留病(MRD)检测灵敏度达到10-5~10-6,具有更高敏感性,而新一代的质谱流式细胞术将更有助于评估治疗反应和理解耐药机制。Multiple myeloma(MM)is a multifocal plasma cell tumor,arising from bone marrow,which is associated with serum and/or urinary M-protein.And it invades bone marrow extensively in most cases.Clinical manifestations vary significantly,from symptomless to invasion,and they are mainly due to abnormal immunoglobulin chain deposition.Recently,the treatment of multiple myeloma has undergone great changes,which considerably improved the remission rate of multiple myeloma,but its recurrence rate is also high,indicating that the existing detection methods can not detect some minor persistent abnormalities.Though traditional monitoring methods such as the morphology of peripheral blood and bone marrow cells and the imageology are still important,allele-specific polymerase chain reaction,new-generation sequencing(NGS)and multicolor flow cytometry enable minimal residual disease(MRD)detection have the higher sensitivity up to 10-5 to 10-6.The flow cytometry with mass spectrometry(MS)will help assess responses to novel therapeutics and increase our understanding of mechanisms of resistance.

关 键 词：多发性骨髓瘤 最小残留病灶检测 流式细胞术 下一代测序 聚合式多聚酶链反应 

分 类 号：R739.42[医药卫生—肿瘤]