160例多发性骨髓瘤患者免疫表型特征及其临床意义

Immunophenotype Characteristics in 160 Cases of Patients with Multiple Myeloma and Their Clinical Significance

目的：研究多发性骨髓瘤（MM）细胞免疫表型特征及其临床意义。方法：应用直接免疫荧光抗体染色方法,采用四色流式细胞仪分析160例多发性骨髓瘤患者瘤细胞免疫表型特征。结果：160例MM患者中CD38、CD138均为阳性,CD7、CD34、CD3、CD10均为阴性,其他抗体阳性率分别为CD56（61.5%）、CD117（18.8%）、CD19（6.5%）、CD20（12.5%）、cKappa（71.0%）、cLambda（76.3%）、CD81（58.1%）、CD45（46.9%）、CD27（14.3%）、CD28（17.4%）、CD33（21.4%）。CD20在小于60岁患者中的表达明显高于60岁以上患者[（78.91±16.84）%vs（38.31±11.29）%（P〈0.05）,CD28在大于60岁患者中的表达明显高于小于60岁的患者[（70.81±19.44）%vs（43.97±11.25）%]（P〈0.05）。CD28、CD45在女性患者中的表达明显高于男性患者[（71.75±25.20）%vs（47.25±12.04）%]（P〈0.05）、[（74.04±19.07）%vs（48.42±25.10）%]（P〈0.05）。CD20的表达在Ⅲ期患者明显高于Ⅰ期和Ⅱ期患者[（84.82±11.25）%vs（42.01±7.15）%]（P〈0.05）,而CD117的表达与此相反[（49.13±14.06）%vs（77.07±25.92）%]（P〈0.05）。在女性患者中,CD81的表达在60岁以上的患者中明显升高[（43.87±24.43）%vs（74.59±22.94）%]（P〈0.05）。在小于50岁的患者中,女性CD117的阳性率明显高于男性[（83.4±0.42）%vs（45.75±2.19）%]（P〈0.05）,而CD81的表达与此相反[（39.20±24.14）%vs（81.52±22.05）%]（P〈0.05）;在51-60岁的患者中,男性患者CD33的表达明显高于女性[（94.53±3.06）%vs（45.37±15.28）%]（P〈0.05）;在60-70岁的患者中,各分子的表达在男女之间无显著统计学差异。在大于70岁的患者中,男性CD117的表达明显高于女性[（70.40±31.40）%vs（53.50±29.98）%]（P〈0.05）,而c Kappa的表达与此相反[（32.58±13.90）%vs（76.98±22.42）%]（P〈0.05）。结论：骨髓瘤细胞表达以CD38、CD138抗原为主,仅部分患者可伴有抗原CD56、CD117、CD19、CD20、cKappa、cLambda、CD81、CD45、CD27、CD28、CD33的表达。

Objective： To investigate the immunophenotype characteristics in multiple myeloma （MM） patients and their clinical significance. Methods： Immunophenotype characteristics of 160 cases of patients with multiple myelomawereanalyzed in direct immunofluorescence antibody staining by the four-color flow cytometry. Results： In these 160 casesofpatients, the expression of CD38 and CD138 were all positive,while CD7, CD34, CD3, CD10 were all negative, and the other antigen positive expression rate of myeloma cells was as follows： CD56 （61.5%）, CD117 （18.8%）, CD19 （6.5%）, CD20 （12.5%）, cKappa （71.0%）, cLambda （76.3%）, CD81 （58.1%）, CD45 （46.9%）, CD27 （14.3%）, CD28 （17.4%）, CD33 （21.4%）. The expression of CD20 was significantly higher in patients aged under 60 years, while CD28 was decreased. CD28, CD45 was obviously higher in female compared with male patients. Compared with the MM patients in stage III, the expression of CD20 was increased dramatically in stage I and II, while CD 117 was decreased. In female patients, CD81 was mainly expressed in patients over 60. In patients less than 50 years old, CD 117 positive rate was significantly higher in the femalethanthat of the male, while the expression of CD81 was on the contrary. In patients aged between 51 and 60, the expression of CD33 in male patients was obviously higher than that of female; In patients aged between 61 and 70, there was no statistically significant difference about the antigen molecular expression between the men and women.In patients over 70 years, CD117 was significantly higher in the male than that of the female, while the expression of cKappa was on the contrast. Conclusion： The emyeloma cellsmainly express the antigens CD38 and CD138, while the expressions of CD56, CD117, CD19, CD20, cKappa, cLambda, CD81, CD45, CD27, CD28,CD33 were seen only in some MM patients.