多参数流式细胞术对多发性骨髓瘤患者的诊断和预后预测价值  

The value of multi-parameter flow cytometry in the diagnosis and prognosis prediction of patients with multiple myeloma

作　　者：王洪建[1] 刘燕飞 李智全 纪国超[1] 武欣 李志春[1] WANG Hongjian;LIU Yanfei;LI Zhiquan;JI Guochao;WU Xin;LI Zhichun(Clinical Laboratory,Puyang People’s Hospital,Puyang 457000,He’nan,China)

机构地区：[1]濮阳市人民医院检验科,河南濮阳4570000

出　　处：《癌症进展》2021年第13期1359-1362,1366,共5页Oncology Progress

摘　　要：目的研究多参数流式细胞术对多发性骨髓瘤(MM)患者的诊断和预后预测价值。方法选取86例MM患者作为观察组,再选择同期自愿接受多参数流式细胞术检查的健康体检人群40例作为对照组。采用多参数流式细胞术检测两组受试人群免疫表型(CD19、CD117、CD56、CD138、CD38)异常克隆浆细胞表达情况,统计观察组总生存率及不同免疫表型阳性和阴性患者总生存率;使用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析不同免疫表型对MM患者的预后预测价值,并以CD45/SS设门,分析不同组合[CD38(+)/CD138(+)/CD19(-)、CD38(+)/CD138(+)/CD19(-)/CD56(+)、CD38(+)/CD138(+)/CD19(-)/CD117(+)]对MM患者的预后预测价值。结果两组受试者CD138阳性率比较,差异无统计学意义(P﹥0.05);观察组患者CD19阳性率明显低于对照组,CD117、CD56、CD38阳性率均明显高于对照组,差异均有统计学意义(P﹤0.01)。ROC曲线分析结果显示,CD19、CD117、CD138、CD38免疫表型对MM患者的预后预测价值有限(AUC﹤0.6),CD56免疫表型对MM患者有一定的预后预测价值(AUC﹥0.6)。不同组合对MM患者的预后预测价值均高于免疫表型(P﹤0.05),且CD38(+)/CD138(+)/CD19(-)的AUC最大,提示其预后预测价值最高。结论多参数流式细胞术中免疫表型分析可为MM患者诊断提供一定参考价值,不同组合在预后预测中有较高的应用价值。Objective To study the diagnostic and prognostic value of multi-parameter flow cytometry in patients with multiple myeloma(MM).Method A total of 86 patients with MM were selected as the observation group,and 40 healthy people who voluntarily received multi-parameter flow cytometry examination in the same period were selected as the control group.The expression of abnormal clonal plasma cells(CD19,CD117,CD56,CD138 and CD38)in the two groups was compared by multi-parameter flow cytometry,and the overall survival rate of the observation group,the patients with positive and negative immunophenotype were compared.Receiver operating characteristic(ROC)curve and area under the curve(AUC)was used to analyze the prognostic value of different immunophenotypes in patients with MM,and CD45/SS was used as the gate.The prognostic value of different combinations[CD38(+)/CD138(+)/CD19(-),CD38(+)/CD138(+)/CD19(-)/CD56(+),CD38(+)/CD138(+)/CD19(-)/CD117(+)]for MM patients were analyzed.Result There was no significant difference in the positive rate of CD138 between the observation group and the control group(P>0.05).The positive rate of CD19 in the observation group was lower than that in the control group,the positive rates of CD117,CD56,CD38 in the observation group were higher than those in the control group,the differences were statistically significant(P<0.01).The ROC curve showed that the immunophenotype of CD19,CD117,CD138 and CD38 had limited value in predicting the prognosis of patients with MM(AUC<0.6),while the immunophenotype of CD56 had certain predictive value in the prognosis of patients with MM(AUC>0.6).The prognostic value of different gates in patients with MM was higher than that of immunophenotype(P<0.05),and the AUC of CD38(+)/CD138(+)/CD19(-)was the largest,suggesting that the best diagnostic value.Conclusion Immunophenotype analysis in multi-parameter flow cytometry can provide certain reference value for diagnosis of MM patients,and it has high application value in predicting prognosis with different combina

关 键 词：多发性骨髓瘤 多参数流式细胞术 免疫表型 预后预测 

分 类 号：R733.3[医药卫生—肿瘤]