多发性骨髓瘤中骨髓瘤细胞免疫表型检测及其意义

Detection of immunophenotypic characteristics of myeloma cells in multiple myeloma and its significance

目的探讨多发性骨髓瘤(multiple myeloma,MM)患者骨髓瘤细胞免疫表型特点及其意义。方法应用直接免疫荧光法,利用流式细胞仪检测17例MM患者骨髓瘤细胞(CD19-CD38+)表面分化抗原CD56、CD117、CD138的表达特点。结果 17例MM患者中有13例(76.47%)CD56表达阳性,15例患者中有5例(33.33%)CD117表达阳性,9例患者中有4例(44.44%)CD138表达阳性;CD56、CD117、CD138的表达率与形态学骨髓瘤细胞比率之间无相关关系;CD117表达与患者贫血程度有关(P<0.01),CD117阴性时,患者贫血程度较重;而CD56表达与贫血程度无关;CD56、CD117的表达与不同的临床分期、疗效和是否有骨破坏无关;在对抗原表达情况与M蛋白分型关系的分析中发现在CD56阴性的4例患者中,有3例为不分泌型。结论骨髓瘤细胞免疫表型具有一定特点,并与临床表现有一定的关系。

Objective To investigate the significance of immunophenotypic characteristics of myeloma cells in patients with multiple myeloma（MM）.Methods The expression of CD56,CD117,CD138 on myeloma cells in 17 MM patients were examined by a direct immunofluorescent straining technique and analyzed by 3-colour flow cytometry.Results Among 17 patients with MM,13（76.47%）had positive CD56 expression on myeloma cells,5（33.33%）had positive CD117 expression,and 4（44.44%）had positive CD138 expression;Expression of CD56,CD117,CD138 antigens was not positive correlated with the proportion of MM cells in morphology in bone marrow;There was some relation between CD117 and the level of anemia of patients,and it was more serious when CD117 was negative;But there was no relation between CD56 and the level of anemia;There was no relation between the expression of CD56,CD117 and different stages,therapeutic effect,anemia,osteoclasia either.It was discovered in the analysis of the relation between the expression and the type of M protein that among 4 patients with CD56 negative,there were 3 patients were all unsecretion type.Conclusion The immunophe notye of myeloma cells has its own characters.There is some relation between the expression of these antigens and the clinical manifestation of MM patients.