多发性骨髓瘤浆细胞核中AgNOR检测的临床意义

Clinical Significance of AgNOR Examination in Patients with Multiple Myeloma

为研究多发性骨髓瘤（MM）与反应性浆细胞增多症（RP）、MMIB与MMNA以及MM治疗前后的骨髓浆细胞嗜银蛋白染色（AgNOR）形态颗粒数量的变化，用AgNOR技术．测定各级AgNOR形态及颗粒数量。结果显示，AgNOR形态在MM组中有单一型、弥漫型、聚集型、核仁形，在RP组中只有单一型，AgNOR颗粒均数在MM组中为6．21±4．12，RP组为202±063，两组间有非常显著性差异（P＜0．001）；MMⅢB和ⅢA组，形态及颗粒均数无差异。17例MM治疗前、后各种形态中颗粒比较差别有显著性（P＜0．001）。提示骨髓中浆细胞AgNOR形态及颗粒数量对鉴别良、恶性浆细胞具有一定临床意义，同时也证实了AgNOR法对了解MM中浆细胞增殖水平及预后是一个简单有效的参考指标。

objective To explore the clinical significance of argyrophilic nucleolar organizer reglon (AgNOR) examination in multiple myeloma (MM) and reactive plasmacytosys (RP)' Method Grain number and morpholoical types of AgNOR were studled using AgNOR staining technique' Results: There were 4 morphological types-of AgNOR in cells from MM including nucleolar, diffused, clustered and intranucleolar types, but a singular nucleolar type was found in RP. The mean grain number of AgNOR is much higher in cells from MM (6. 21 ±4. 12) than RP (2' 02±0' 63) (P < 0. 001 ), and it reduced sharply after effective treatment in 17 cases of MM (P < 0' 001 )' Conclusion The results indicated that AgNOR examinition is helpful in differentiation of MM and RP, and may be related to prognosis of MM' It also proved that AgNOR staining is a simple and useful index to judge the proliferation level of plasma cells.