多发性骨髓瘤增殖与凋亡的研究

Proliferation and Apoptosis in Multiple Myeloma

目的了解多发性骨髓瘤（multiplemyeloma，MM）中瘤细胞凋亡与增殖之间的关系及最终造成浆细胞数目异常增多，形成MM的发病机制。方法运用末端脱氧核着酸转移酶介导的脱氧尿毒三磷酸缺口末端标记（TUNEL）技术，结合HE形态和免疫组化结果，半定量分析12例MM中瘤细胞的凋亡与增殖的情况。结并MM瘤细胞增殖水平低，凋亡水平也低于常见人类肿瘤的平均凋亡水平，在瘤细胞聚积成给节或弥漫浸润时，给节中无TUNEL阳性标记细胞，瘤细胞的凋亡与增殖之间呈正相关（P＜0.05）。结论在MM中，造成瘤细胞数量异常增多形成肿瘤的重要原因是凋亡的减少。

Objective To understand the role of deregulation of apoptosis in the pathogenesis of multiple myeloma (MM). Methods Apoptosis has been quantitatively studied in paraffin sections from 12 MM cases by method of TdT - mediated dUTP nick end labeling technique (TUNEL). Proliferative activities were measured by immunostaining of PCNA. The plasma cells clonality was assessed by demonstrating light chain restriction. Results The extent of apoptosis was correlated with PCNA and the level of apoptosis in MM is lower than the intermediate level in many of the common human cancers. When myeloma cells gradually formed nodule or displayed diffuse growth pattern,no TUNEL positive stain could be found in majority of the myeloma cells. The correlation analysis revealed a positive association between the number of apoptotic and proliferative cells. Conclusion The MM was a low proliferative neoplasm due to the decrease of apoptosis in myeloma cells.