不同预后分层的多发性骨髓瘤患者免疫表型特征分析

Immunophenotype Characteristics of Patients with Multiple Myeloma in Different Risk Stratification

本研究探讨不同预后分层的初诊多发性骨髓瘤患者的免疫表型特点。采用流式细胞仪多参数直接免疫荧光技术,CD45/SSC和CD38/SSC联合设门,对62例初诊的多发性骨髓瘤患者骨髓标本标记CD45、CD38、CD138、CD56、CD19、CD117、CD13、CD20、CD22、CD34、Kappa和Lambda进行检测,并通过ISS分期及细胞遗传学特征进行预后分层,分析和比较不同预后分组患者的免疫表型特点。结果显示:异常浆细胞均表达CD138(100%)及CD38(100%),而CD19+(6.5%),CD45+(22.6%),CD56+(59.6%)及单克隆轻链抗原表达(82%)相对常见,其他CD117+(27.4%),CD13+(17.7%),CD20+(16.1%)存在个体差异;经预后分层后显示,标高、高危组CD56表达率低于低危组(P=0.02),而CD117表达率高于低危组(P=0.011)。结论:多发性骨髓瘤免疫表型具有异质性,在初诊的中、高危患者中CD56表达较低,而CD117表达较高,这可能与不良预后相关。

This study assessed the immunophenotype characteristics of newly diagnosted patients with multiple myeloma（ MM） in different risk stratification in order to find the relationship between the immunophenotype and prognosis of MM.The expressions of CD45,CD38,CD138,CD56,CD19,CD117,CD13,CD20,CD22,CD34 KappaLambda in bone marrow samples from 62 newly diagnosed MM patients were detected by using flow cytometric multiparametric direct immunofluorescence technigueCD45 /SSC and CD38 /SSC combination gatingthen the immumophemotypic characteristics of patients in different risk stratification groups were analyzed and compared.The new risk stratification of all patients was carried out according to ISS stages（ Interuational Staging System） and cytogenetic characteristics.The results indicated that all the malignant plasma cells commonly expressed CD38（100%）and CD138（100%）; CD19^ ＋（ 6.5%）,CD45^ ＋（ 22.6%）,CD56 ^＋（ 59.6%）and monoclonal light chain（82%）; but the expressions of CD117^ ＋（ 27.4%）,CD13 ^＋（ 17.7%）,CD20^ ＋（ 16.1%）were diverse.According to risk stratificationit is found that the standard-risk and high-risk groups had lower expression of CD56（ P = 0.022） and higher expression of CD117（ P = 0.011）,compared with the low-risk group.It is concluded that the immunophenotype of MM is heterogeneitythe lower expression of CD56 and higher expression of CD117 may be associate with poor prognosis.