多发性骨髓瘤常用表面抗原的生物活性和预后意义

Biological Activity and Prognostic Significance of Common Surface Antigens in Multiple Myeloma

多发性骨髓瘤(multiple myeloma, MM)是一种复杂的异质性疾病,积聚在骨髓中的异常克隆性浆细胞(plasma cells, PC)不受控制和破坏性的生长,最终导致多种组织器官损害。MM的进展依赖于其与骨髓微环境和免疫系统的相互作用,并由关键的表面抗原介导。一些抗原促进与骨髓基质和基质细胞的黏附,而另一些则参与细胞间的相互作用,导致B细胞向PC的分化。这些相互作用也参与了正常PC向MM PC的恶变以及疾病的进展。我们综述了在MM的流式细胞术中常用的一些表面抗原,用于鉴定PC、区别正常和恶性PC以及预测预后。这些标记物包括:CD38、CD138、CD45、CD27、CD19、CD28、CD56、CD81、CD117和CD24。综述了每种抗原的生物活性,以及它在正常和恶性PC中的表达情况、预后意义和治疗潜力。了解这些特定表面抗原的作用,可以对MM患者进行更个性化的预后监测和治疗。

Multiple myeloma is a complex heterogeneous disease with uncontrolled and destructive growth of abnormal clonal plasma cells accumulated in the bone marrow, resulting in a variety of tissue and organ damage. The progression of multiple myeloma depends on its interaction with the bone mar-row microenvironment and immune system, and is mediated by key surface antigens. Some anti-gens promote adhesion to bone marrow stroma and stromal cells, while others participate in cell-to-cell interaction, leading to the differentiation of B cells into plasma cells. These interactions are also involved in the malignant transformation of normal plasma cells to myeloma plasma cells and the progression of the disease. We review some surface antigens commonly used in flow cytom-etry of multiple myeloma to identify plasma cells, distinguish normal and malignant plasma cells, and predict prognosis. These markers include: CD38, CD138, CD45, CD27, CD19, CD28, CD56, CD81, CD117 and CD24. The biological activity of each antigen, its expression in normal and malignant plasma cells, prognostic significance and therapeutic potential were reviewed. Understanding the role of these specific surface antigens can provide more personalized prognostic monitoring and treatment for patients with multiple myeloma.