川东北地区MM患者骨髓瘤细胞免疫表型特征及其临床意义  

Immune Phenotype Characteristics and Clinical Significance of Myeloma Cells in Patients with MM in Northeastern Sichuan

作　　者：祝静 龙思琪[1] 蒋瑶 王静 刘文[1,2] ZHU Jing;LONG Si-qi;JIANG Yao;WANG Jing;LIU Wen(Department of Medical Laboratory Science,North Sichuan Medical College,Nanchong 637000,Sichuan,China;Department of Laboratory Medicine,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China;Department of Hematology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院医学检验系,四川南充637000 [2]川北医学院附属医院检验科,四川南充637000 [3]川北医学院附属医院血液科,四川南充637000

出　　处：《医学信息》2021年第10期88-91,共4页Journal of Medical Information

基　　金：川北医学院校级科研发展计划项目(编号:CBY18-A-YB52)。

摘　　要：目的明确我国川东北地区多发性骨髓(MM)患者骨髓瘤细胞免疫表型的特征及其临床意义。方法流式细胞术检测川北医学院附属医院2018年1月~2020年1月血液科住院的MM患者骨髓瘤细胞的免疫表型,分析CD38、CD138、CD19、CD56、CD20、CD117、CD27、CD28、CD33、cKappa、cLambda在不同临床分期之间表达率的差异以及其与病情评估指标LDH、白蛋白、β2-MG、血红蛋白的关系。结果川东北地区MM患者骨髓瘤细胞CD分子的阳性表达率从高到低依次为CD38(100.00%)、CD138(100.00%)、CD56(77.88%)、CD19(55.77%)、cLambda(55.77%)、CD28(54.81%)、CD117(48.28%)、CD27(44.23%)、cKappa(44.23%)、CD33(26.92%)、CD20(21.15%)。ISS不同分期CD27的阳性表达率比较,差异有统计学意义(P<0.05);CD56^(+)组LDH、白蛋白低于D56^(-)组,CD117^(+)组白蛋白水平高于CD117^(-)组,CD27^(+)组β2-MG低于CD27^(-)组,CD28^(+)组的血红蛋白高于CD28^(-)组(P<0.05);CD19^(+)组与CD19-组、CD20^(+)组与CD20^(-)组及CD33^(+)组与CD33^(-)组血清LDH、β2-MG、白蛋白及血红蛋白分别比较,差异无统计学意义(P>0.05)。结论骨髓瘤细胞的免疫表型具有高度异质性和地域差异,CD27的表达阳性率越低,ISS分期越晚,可能病情更重。CD27^(+)、CD56^(+)、CD117^(+)及CD28^(+)患者的疾病活动度、肿瘤负荷、肿瘤消耗及瘤细胞可能对骨髓的浸润及抑制程度均分别的低于相应的阴性患者。Objective To clarify the characteristics and clinical significance of the immunophenotype of myeloma cells in patients with multiple myeloma(MM)in northeastern Sichuan.Methods Flow cytometry was used to detect the immunophenotype of myeloma cells in MM patients hospitalized in the Department of Hematology from January 2018 to January 2020 in the Affiliated Hospital of North Sichuan Medical College.Analyzing the differences in the expression rates of CD38,CD138,CD19,CD56,CD20,CD117,CD27,CD28,CD33,cKappa,and cLambda between different clinical stages and their relationship with disease evaluation indicators LDH,albumin,β2-MG,and hemoglobin.Results The positive expression rate of CD molecules in myeloma cells of MM patients in Northeast Sichuan was CD38(100.00%),CD138(100.00%),CD56(77.88%),CD19(55.77%),and cLambda(55.77%),CD28(54.81%),CD117(48.28%),CD27(44.23%),cKappa(44.23%),CD33(26.92%),CD20(21.15%).The positive expression rate of CD27 in different stages of ISS was compared,the difference was statistically significant(P<0.05);CD56^(+)group LDH and albumin were lower than D56^(-)group,CD117^(+)group albumin level was higher than CD117^(-)group,CD27^(+)groupβ2-MG was lower than CD27^(-)group,CD28^(+)group had higher hemoglobin than CD28^(-)group(P<0.05);There was no significant difference in serum LDH,β2-MG,albumin and hemoglobin between CD19^(+)group and CD19-group,CD20^(+)group and CD20^(-)group,and CD33^(+)group and CD33^(-)group respectively(P>0.05).Conclusion The immunophenotype of myeloma cells is highly heterogeneous and regionally different.The lower the positive rate of CD27 expression,the later the stage of ISS,and the more severe the disease may be.CD27^(+),CD56^(+),CD117^(+)and CD28^(+)patients'disease activity,tumor burden,tumor wasting,and tumor cell infiltration and inhibition of bone marrow may be lower than the corresponding negative patients.

关 键 词：多发性骨髓 免疫表型 血液肿瘤 

分 类 号：R733.3[医药卫生—肿瘤]