流式细胞技术在多发性骨髓瘤诊断中的应用研究

Application of flow cytometry in the diagnosis of multiple myeloma

目的:探讨CD38/138/45/SSC及CD38/56/19/45/SSC四色组合流式细胞术在多发性骨髓瘤(MM)患者诊断中的临床应用。方法:采用多参数流式细胞技术,通过CD38/CD45双抗体设门,以CD38/138/45/SSC及CD38/56/19/45/SSC四色组合检测33例确诊MM患者骨髓中的浆细胞,并进行浆细胞胞浆κ/λ的检测。结果:33例MM患者中均可检测到CD38^(++)/CD138^+/CD45^(+/-)细胞群,在该细胞群中并未找到56^-/19^+的正常浆细胞,免疫表型为45^-/56^+/19^-标本26例,占79%,45^-/56^-/19^-标本5例,占15%,45^+/56^+/19^-标本2例,占6%。对上述CD38^(++)/138^+标本进行胞浆κ/λ检测,均为单克隆瘤细胞。结论:CD38/138/45/SSC及CD38/56/19/45/SSC四色流式细胞检测能精确发现恶性变的浆细胞,在MM诊断中有重要的临床意义和诊断价值。

Objective：To explore the diagnosis value of CD38/138/45/SSC and CD38/56/19/45/SSC four colour flow cytometry panel in multiple myeloma（MM）.Method：We used the CD38/CD45 double antibody setting gate with CD38/138/45/SSC and CD38/56/19/45/SSC four colour panel to analyze bone marrow cytoplasm of 33 cases with MM,and detected cytoplasmκ/λin all cases.Result：All of 33 cases could be found out the CD38^＋＋/CD138^＋/CD45^＋/- cells.The normal plasma cells of CD56^-/CD19^＋cannot be found in the group.There were 26cases（79%）of 45^-/56^＋/19^-,5cases（15%）of 45^-/56^-/19^-and 2cases（6%）of 45^＋/56^＋/19^-.All the cases with cytoplasmκ/λdetection were confirmed monoclonal tumor cells.Conclusion：The use of CD38/138/45/SSC and CD38/56/19/45/SSC four colour flow cytometry panel can accurately distinguish myeloma cells.It＇s very helpful for the diagnosis of MM.