浆细胞骨髓瘤CD_(56)表达的临床病理及预后意义

The clinicopathological and prognostic significance of CD_(56) expression in plasma cell myeloma

目的CD56在浆细胞骨髓瘤(PCM)中的表达及其临床病理和预后提示意义。方法选取浆细胞骨髓瘤22例为研究对象,同时选取原发的髓外浆细胞瘤(EMP)3例和反应性浆细胞增生5例进行对比研究。S-P免疫组化染色方法检测CD56在不同病变中的表达。结果反应性浆细胞增生及原发的EMP中均无CD56表达,而9例(41%)PCMCD+56。CD+56患者的整体生存时间和无疾病生存时间长于CD5-6者(log-rank检验,P<0.05)。CD56表达与患者年龄、临床分期和组织学分级均无相关性(P<0.05)。结论CD56是PCM较常见、较特异的一个免疫表型,但不能将其作为确定PCM中具独特临床病理学特点亚群的标记,只是PCM的一个预后提示因子。此外,CD56可能是鉴别原发EMP和PCM髓外浸润的一个有意义的标记。

Objective To investigate the aberrant CD56 expression in plasma cell myeloma and its clinical significance. Methods Detection of CD56 expression PCM were performed on the formalin- fixed, paraffin- embedded sections by SP method and 5 biopsy samples from reactive plasmacytosis and 3 primary EMP were studied in parallel. The statistical analysis were done by SPSS11.0 software. All the differences were considered statistically significant at P <0.05. Results Both PCs from reactive plasmacytosis and neoplastic PCs from primary EMP showed absence of CD56, while 9 out of 22(41%) patients with PCM were detected with CD56 expression, including 1 with extramedullary relapses. For survival analysis, significant differences were observed regarding overall survival or event- free survival between CD-56 and CD+56 patients with PCM (P <0.05, log rank test). In addition, there existed no marked differences in age, clinical stages and histological grades with CD56 expressions. Conclusions We conclude that aberrant expression of CD56 molecule by malignant PCs was common and special in PCM and absence of CD56 in PCM was significantly correlated with a shorter overall and event- free survival (P<0.05, log rank test). Thus, absence of CD56 may be useful for the prediction of PCM with aggressive potential and a shorter survival. In addition, maybe it is a useful marker for discriminating extramedullary involvement by PCM from primary EMP.