中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2014年
9期
687-690
,共4页
林向华%谢晓英%肖旺贤%罗晓红%陈凤平%林帝金%段朝晖
林嚮華%謝曉英%肖旺賢%囉曉紅%陳鳳平%林帝金%段朝暉
림향화%사효영%초왕현%라효홍%진봉평%림제금%단조휘
多发性骨髓瘤%免疫表型分型%流式细胞术
多髮性骨髓瘤%免疫錶型分型%流式細胞術
다발성골수류%면역표형분형%류식세포술
Multiple myeloma%Immunophenotyping%Flow cytometry
目的:探讨流式细胞术检测浆细胞骨髓瘤的非典型免疫表型特征及其临床意义。方法采用病例对照性研究,收集中山大学孙逸仙纪念医院和暨南大学附属第一医院2011年1月至2013年12月住院或门诊非典型免疫表型特征浆细胞骨髓瘤患者48例。此48例非典型免疫表型特征浆细胞骨髓瘤患者为研究对象,42例免疫表型、骨髓形态学及血清免疫固定电泳结果均正常的病例作为对照组,运用流式细胞仪检测其特异性CD抗原标志,并根据非典型免疫表型特征浆细胞骨髓瘤患者流式检测结果,按照 CD38、CD138、CD19、CD56的表达情况将其分为 CD38+/CD138+/CD19+/CD56+、CD38+/CD138+/CD19+/CD56-、CD38+/CD138+/CD19-/CD56-3组,进一步比较这3组胞浆内免疫球蛋白轻链( cKappa、cLambda)表达情况,并结合骨髓形态学及血清免疫固定电泳结果进行分析比较。样本率的比较采用χ2检验。结果48例具非典型免疫表型特征浆细胞骨髓瘤患者中,抗原表达率分别为:CD4529.17%、CD38100%、CD138100%、CD1995.83%、CD5643.75%、cKappa 43.75%和 cLambda 56.25%。3组患者的克隆性免疫球蛋白表达率分别为43.75%、52.08%和4.17%;骨髓形态学及血清免疫固定电泳阳性率分别为57.14%、80%、100%及71.43%、88%、100%。流式细胞术、骨髓形态学及血清免疫固定电泳3种检测方法阳性检出率分别为100%、70.83%及81.25%。而对照组抗原表达率分别为:CD4547.62%、CD38100%、CD138100%、CD19100%、CD560%、cKappa 100%和cLambda 100%,骨髓形态学检查未见异常浆细胞,血清免疫固定电泳均未发现异常单克隆条带。结论多参数流式细胞术相对于骨髓形态学及血清免疫固定电泳的检测方法,更有助于检出非典型免疫表型的浆细胞骨髓瘤,更好地区分良恶性浆细胞,辅助临床对浆细胞骨髓瘤患者的诊断,为其治疗及预后监测提供依据。(中华检验医学杂志,2014,37:687-690)
目的:探討流式細胞術檢測漿細胞骨髓瘤的非典型免疫錶型特徵及其臨床意義。方法採用病例對照性研究,收集中山大學孫逸仙紀唸醫院和暨南大學附屬第一醫院2011年1月至2013年12月住院或門診非典型免疫錶型特徵漿細胞骨髓瘤患者48例。此48例非典型免疫錶型特徵漿細胞骨髓瘤患者為研究對象,42例免疫錶型、骨髓形態學及血清免疫固定電泳結果均正常的病例作為對照組,運用流式細胞儀檢測其特異性CD抗原標誌,併根據非典型免疫錶型特徵漿細胞骨髓瘤患者流式檢測結果,按照 CD38、CD138、CD19、CD56的錶達情況將其分為 CD38+/CD138+/CD19+/CD56+、CD38+/CD138+/CD19+/CD56-、CD38+/CD138+/CD19-/CD56-3組,進一步比較這3組胞漿內免疫毬蛋白輕鏈( cKappa、cLambda)錶達情況,併結閤骨髓形態學及血清免疫固定電泳結果進行分析比較。樣本率的比較採用χ2檢驗。結果48例具非典型免疫錶型特徵漿細胞骨髓瘤患者中,抗原錶達率分彆為:CD4529.17%、CD38100%、CD138100%、CD1995.83%、CD5643.75%、cKappa 43.75%和 cLambda 56.25%。3組患者的剋隆性免疫毬蛋白錶達率分彆為43.75%、52.08%和4.17%;骨髓形態學及血清免疫固定電泳暘性率分彆為57.14%、80%、100%及71.43%、88%、100%。流式細胞術、骨髓形態學及血清免疫固定電泳3種檢測方法暘性檢齣率分彆為100%、70.83%及81.25%。而對照組抗原錶達率分彆為:CD4547.62%、CD38100%、CD138100%、CD19100%、CD560%、cKappa 100%和cLambda 100%,骨髓形態學檢查未見異常漿細胞,血清免疫固定電泳均未髮現異常單剋隆條帶。結論多參數流式細胞術相對于骨髓形態學及血清免疫固定電泳的檢測方法,更有助于檢齣非典型免疫錶型的漿細胞骨髓瘤,更好地區分良噁性漿細胞,輔助臨床對漿細胞骨髓瘤患者的診斷,為其治療及預後鑑測提供依據。(中華檢驗醫學雜誌,2014,37:687-690)
목적:탐토류식세포술검측장세포골수류적비전형면역표형특정급기림상의의。방법채용병례대조성연구,수집중산대학손일선기념의원화기남대학부속제일의원2011년1월지2013년12월주원혹문진비전형면역표형특정장세포골수류환자48례。차48례비전형면역표형특정장세포골수류환자위연구대상,42례면역표형、골수형태학급혈청면역고정전영결과균정상적병례작위대조조,운용류식세포의검측기특이성CD항원표지,병근거비전형면역표형특정장세포골수류환자류식검측결과,안조 CD38、CD138、CD19、CD56적표체정황장기분위 CD38+/CD138+/CD19+/CD56+、CD38+/CD138+/CD19+/CD56-、CD38+/CD138+/CD19-/CD56-3조,진일보비교저3조포장내면역구단백경련( cKappa、cLambda)표체정황,병결합골수형태학급혈청면역고정전영결과진행분석비교。양본솔적비교채용χ2검험。결과48례구비전형면역표형특정장세포골수류환자중,항원표체솔분별위:CD4529.17%、CD38100%、CD138100%、CD1995.83%、CD5643.75%、cKappa 43.75%화 cLambda 56.25%。3조환자적극륭성면역구단백표체솔분별위43.75%、52.08%화4.17%;골수형태학급혈청면역고정전영양성솔분별위57.14%、80%、100%급71.43%、88%、100%。류식세포술、골수형태학급혈청면역고정전영3충검측방법양성검출솔분별위100%、70.83%급81.25%。이대조조항원표체솔분별위:CD4547.62%、CD38100%、CD138100%、CD19100%、CD560%、cKappa 100%화cLambda 100%,골수형태학검사미견이상장세포,혈청면역고정전영균미발현이상단극륭조대。결론다삼수류식세포술상대우골수형태학급혈청면역고정전영적검측방법,경유조우검출비전형면역표형적장세포골수류,경호지구분량악성장세포,보조림상대장세포골수류환자적진단,위기치료급예후감측제공의거。(중화검험의학잡지,2014,37:687-690)
Objective To investigate the characteristics and significance of atypical flow cytometric immunophenotype in plasma cell myeloma.Methods Using case-control study , 48 cases with atypical immunophenotype of plasma cell myeloma and 42 cases as control group were studied by flow cytometry , the former cases were classified into three groups according to the expression of CD 38, CD138, CD19, CD56 :CD38 +/CD138 +/CD19 +/CD56 +, CD38 +/CD138 +/CD19 +/CD56 -, CD38 +/CD138 +/CD19 -/CD56 -.And compare the three groups with intracellular immunoglobulin light chain (cKappa, cLambda) , bone marrow morphology and immunofixation.The positive rate was compared with chi-square test.Results Bone marrow plasma cells showed expression of particular antigens in the following proportion of the 48 cases:CD45 29.17%, CD38 100%, CD138 100%, CD19 95.83%, CD56 43.75%, cKappa 43.75%and cLambda 56.25%.And in the three groups , the expression of monoclonal immunoglobulin were 43.75%, 52.08%and 4.17%, which bone marrow morphology and immunofixation were 57.14%,80%, 100%and 71.43%,88%,100%.The positive rate of flow cytometry , bone marrow morphology and serum immunofixation electrophoresis were 100%, 70.83% and 81.25%.While the expression of particular antigens in the control group were:CD45 47.62%, CD38 100%, CD138 100%, CD19 100%, CD56 0%, cKappa 100% and cLambda 100%.And no abnormalities were detected in bone marrow morphology and immunofixation.Conclusions Compared with the bone marrow morphology and immunofixation , multiparameter flow cytometry has more helpful to find out atypical immune phenotype of plasma cell myeloma, and differentiate malignant and benign plasma cell , contributes to the diagnosis of clinical plasma cell myeloma, prognosis and treatment monitoring.