中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2011年
1期
10-14
,共5页
陈葆国%罗文达%李伯利%郑瑞%颜卫华%石卫武
陳葆國%囉文達%李伯利%鄭瑞%顏衛華%石衛武
진보국%라문체%리백리%정서%안위화%석위무
多发性骨髓瘤%免疫表型分型%肿瘤,残余%流式细胞术
多髮性骨髓瘤%免疫錶型分型%腫瘤,殘餘%流式細胞術
다발성골수류%면역표형분형%종류,잔여%류식세포술
Multiple myeloma%Immunophenotyping%Neoplasm,residual%Flow cytometry
目的 探讨MM细胞免疫表型特征及MRD检测的临床意义.方法 应用多参数流式细胞术检测16名健康对照者和172例MM患者的免疫表型.32例MM患者缓解后作MRD分析,同时进行跟踪随访,分析MRD阳性和阴性对MM患者的复发率和无病生存时间是否存在影响.结果 流式细胞术检测结果显示,16名健康对照者正常浆细胞CD38、CD 138、CD19、CD45均阳性,172例MM患者骨髓瘤细胞主要免疫表型为CD+38 172例(100.0%)、CD+138172例(100.0%)、CD-19 167例(97.1%)、CD+56 152例(88.4%)、CD-45 166例(96.5%),骨髓瘤细胞具有显著的特征性表型,即CD+38、CD+138、CD+56、CD-19、CD-45.32例MM患者缓解后进行MRD检测,其中14例MRD阴性,18例MRD阳性.随访2～16个月后,MRD阴性组4例复发(28.6%),MRD阳性组13例复发(72.2%),两组复发率比较,差异有统计学意义(χ2=6.03,P＜0.05).MRD阴性组累积无病生存时间中位数16.23(10.37～21.62)个月,明显长于MRD阳性组的10.07(3.79～16.20)个月,两组比较差异有统计学意义(χ2=7.53,P＜0.05).结论 MM患者骨髓瘤细胞主要免疫表型特征是CD+38、CD+138、CD1-19、CD-45、CD+56.多发性骨髓瘤MRD检测可以作为临床预后的参考指标.
目的 探討MM細胞免疫錶型特徵及MRD檢測的臨床意義.方法 應用多參數流式細胞術檢測16名健康對照者和172例MM患者的免疫錶型.32例MM患者緩解後作MRD分析,同時進行跟蹤隨訪,分析MRD暘性和陰性對MM患者的複髮率和無病生存時間是否存在影響.結果 流式細胞術檢測結果顯示,16名健康對照者正常漿細胞CD38、CD 138、CD19、CD45均暘性,172例MM患者骨髓瘤細胞主要免疫錶型為CD+38 172例(100.0%)、CD+138172例(100.0%)、CD-19 167例(97.1%)、CD+56 152例(88.4%)、CD-45 166例(96.5%),骨髓瘤細胞具有顯著的特徵性錶型,即CD+38、CD+138、CD+56、CD-19、CD-45.32例MM患者緩解後進行MRD檢測,其中14例MRD陰性,18例MRD暘性.隨訪2～16箇月後,MRD陰性組4例複髮(28.6%),MRD暘性組13例複髮(72.2%),兩組複髮率比較,差異有統計學意義(χ2=6.03,P＜0.05).MRD陰性組纍積無病生存時間中位數16.23(10.37～21.62)箇月,明顯長于MRD暘性組的10.07(3.79～16.20)箇月,兩組比較差異有統計學意義(χ2=7.53,P＜0.05).結論 MM患者骨髓瘤細胞主要免疫錶型特徵是CD+38、CD+138、CD1-19、CD-45、CD+56.多髮性骨髓瘤MRD檢測可以作為臨床預後的參攷指標.
목적 탐토MM세포면역표형특정급MRD검측적림상의의.방법 응용다삼수류식세포술검측16명건강대조자화172례MM환자적면역표형.32례MM환자완해후작MRD분석,동시진행근종수방,분석MRD양성화음성대MM환자적복발솔화무병생존시간시부존재영향.결과 류식세포술검측결과현시,16명건강대조자정상장세포CD38、CD 138、CD19、CD45균양성,172례MM환자골수류세포주요면역표형위CD+38 172례(100.0%)、CD+138172례(100.0%)、CD-19 167례(97.1%)、CD+56 152례(88.4%)、CD-45 166례(96.5%),골수류세포구유현저적특정성표형,즉CD+38、CD+138、CD+56、CD-19、CD-45.32례MM환자완해후진행MRD검측,기중14례MRD음성,18례MRD양성.수방2～16개월후,MRD음성조4례복발(28.6%),MRD양성조13례복발(72.2%),량조복발솔비교,차이유통계학의의(χ2=6.03,P＜0.05).MRD음성조루적무병생존시간중위수16.23(10.37～21.62)개월,명현장우MRD양성조적10.07(3.79～16.20)개월,량조비교차이유통계학의의(χ2=7.53,P＜0.05).결론 MM환자골수류세포주요면역표형특정시CD+38、CD+138、CD1-19、CD-45、CD+56.다발성골수류MRD검측가이작위림상예후적삼고지표.
Objective To investigate the characteristics of immunophenotyping and clinical significance of MRD analysis in MM patients. Methods Multi-parameter flow cytometry was applied to analyze the immunophenotyping of malignant plasma cells from 172 MM patients, and normal plasma cells from 16 healthy individuals. MRD was analyzed in 32 MM patients with remission. Meanwhile, the effects of MRD status on the disease relapse and patient disease free survival ( DFS ) time was evaluated by following up patients. Results The immunophenotyping of normal plasma cells were CD38, CD138, CD19 and CD45 positive, while the predominant phenotype of MM cells were CD+38( 100.0% ), CD+138( 100.0% ), CD-19 ( 167/172, 97. 1% ), CD+56( 152/172, 88.4% ) and CD-45( 166/172, 96. 5% ). The characteristic markers for MM cells were CD+38, CD-138, CD-19, CD-45 and CD+56. MRD analysis revealed that, among 32 MM patients with remission, 14 patients were MRD negative and 18 patients were MRD positive. During follow-up of 2 to 16 months, the relapse rate in MRD negative patients was significantly lower ( 4/14, 28.6% ) than that of MRD positive patients ( 13/18, 72. 2% ;χ2 =6. 03, P ＜0. 05 ). Furthermore, the DFS time was significantly longer in MRD negative patients[ 16. 23( 10. 37-21.62 )months ] than that of the MRD positive patients [ 10. 07( 3. 79-16. 20 )months,χ2 =7. 53,P ＜0. 05 ]. Conclusions CD+38, CD+138, CD-19, CD-45 and CD+56 are the characteristic markers of MM cells compared to those of the normal plasma cells. MRD analysis is a valuable prognostic factor for MM patients.
