多发性骨髓瘤患者骨髓瘤细胞表面Notch1表达水平变化及其临床意义

Change of Notch1 expression level on the surface of myeloma cells in multiple myeloma patients and its clinical significance

目的探讨多发性骨髓瘤(MM)患者骨髓瘤细胞膜表面Notch1表达水平的动态变化及其临床意义。方法选取2013年4月至2019年7月中山大学附属第五医院收治的38例MM患者,同时选取18例轻度缺铁性贫血患者作为对照。应用流式细胞术检测MM患者初诊时(治疗前)、缓解期(治疗中达最好疗效的时期)、进展期(疾病进展期)骨髓瘤细胞表面以及对照组正常浆细胞表面Notch1表达水平。分析疗效,并对MM患者各期与对照者Notch1表达水平进行比较。结果38例MM患者中,严格意义的完全缓解6例(15.8%),完全缓解14例(36.8%),非常好的部分缓解10例(26.3%),部分缓解6例(15.8%);2例(5.3%)在第1个疗程结束后死亡,故36例患者进行了Notch1检测。MM患者初诊时、缓解期、进展期骨髓瘤细胞表面及对照组正常浆细胞表面的Notch1表达率分别为(13.1±3.9)%、(2.7±1.2)%、(5.4±1.7)%、(2.1±0.3)%,差异有统计学意义(F=151.4,P<0.01),MM患者初诊时、进展期Notch1表达率高于缓解期(均P<0.01),而缓解期骨髓瘤细胞表面Notch1表达率高于对照组正常浆细胞表面Notch1表达率(t=2.219,P=0.038)。结论Notch1信号通路在MM的发生和发展中可能发挥重要作用,检测Notch1对MM的监测、治疗和预后评估具有一定的指导意义。

Objective To investigate the dynamic change of Notch1 expression level on the surface of myeloma cells in patients with multiple myeloma(MM)and its clinical significance.Methods A total of 38 patients with MM in the Fifth Affiliated Hospital of Sun Yat-Sen University from April 2013 to July 2019 were selected.At the same time,18 patients with mild iron deficiency anemia were selected as controls.Flow cytometry was used to detect Notch1 expression levels on the surface of myeloma cells for MM patients at the first diagnosis(before the treatment),in remission stage(the time of best effect during the treatment)and in the advanced stage(disease progression),and on the surface of normal plasma cells of the control group.The therapeutic efficacy was analyzed,and the expression levels of Notch 1 were compared among the different stages of MM patients and the control group.Results Among 38 MM patients,6 cases(15.8%)had strict complete remission(sCR),14 cases(36.8%)had complete remission(CR),10 cases(26.3%)had very good partial remission(VGPR),6 cases(15.8%)had partial remission(PR),2 cases(5.3%)died after the first course of treatment.Notch 1 detection was performed in 36 patients.The expression rate of Notch1 on the surface of myeloma cells at the first diagnosis,in remission stage,and in the advanced stage of MM patients and on the surface of normal plasma cells of the control group was(13.1±3.9)%,(2.7±1.2)%,(5.4±1.7)%and(2.1±0.3)%;the difference was statistically significant(F=151.4,P<0.01).The expression rate of Notch1 in MM patients at the first diagnosis and in advanced stage was higher than that in remission stage(all P<0.01),while the expression rate of Notch1 on the surface of myeloma cells in remission stage was higher than that on the surface of normal plasma cells in the control group(t=2.219,P=0.038).Conclusion The Notch1 signaling pathway may play an important role in the occurrence and development of MM,and Notch1 detection has a certain guiding significance for the monitoring,treatment and prognosis assessment of MM.