208例多发性骨髓瘤细胞形态学与血清免疫球蛋白比对分析

Analysis of Cell Morphology and serum immunoglobulin in 208 Patients with Multiple Myeloma

目的回顾分析208例多发性骨髓瘤(MM)病例的骨髓细胞学、临床分型以及血清免疫球蛋白、免疫固定电泳结果 ,探讨其在MM诊断中的作用。方法回顾分析208例MM患者骨髓细胞学特点,按照欧洲血液学会议形态学分型标准将骨髓瘤细胞分型,计数骨髓瘤细胞比例;按临床特点和分期标准将病人分期;记录病人血清免疫球蛋白、免疫固定电泳结果。结果 208例MM病例中:骨髓涂片中骨髓瘤细胞比例≥10%的204例(98.1%),骨髓瘤细胞比例在6.0%-10.0%的3例(1.4%),骨髓瘤细胞比例不增高的1例(0.5%);血清免疫固定电泳:IgG型128例(61%),IgA型47例(22.7%),轻链型28例(13.7%),未分泌型5例(2.8%);临床表现主要有骨破坏168例(80.1%)、贫血163例(79.5%)、骨痛146例(70.1%)、肾功能损害102例(49%)、出血8例(3.8%)、粘滞血症2例(0.9%)。结论骨髓细胞形态学在MM的诊断中尤为重要。血清学特点及明显的临床表现也对MM的诊断有提示作用,三者需紧密结合。

Objective To detect the significance of bone marrow cell morphology and serum immunoglobulin in 208 patients with multiple myeloma（MM） through retrospevtive research,And based on that to evaluate their uses in diagnossis of MM.Methods The clinical features of 208 patients with MM were retrospectively analyzed and further analyzed myeloma cell ratio and morphology type in bone marrow;In mean time datas of serum immunoglobulin are analyzed.Results In 208 patients：Myeloma cell percentage10% in bone marrow slide were 204/98.1%,myeloma cell percentage between 6%-10% are 3/1.4%,no raise1/0.5%;clinical features with MM：osteoclasia（168/80.1%）,anemia（163/79.5%）,osteodynia（146/70.1%）,renal functional abnormality（102/49%）,bleeding（8/3.8%）;serum immunoglobulin：IgG 28/61%,IgA 47/22.7%,light chain type 28/13.7%,no secretion 5/2.8%.Conclusion Morphology of bone marrow cell is an important method in MM diagnosis,while the clinical features,serum immunoglobulin also should be recommended.