【摘要】 目的:探讨多发性骨髓瘤(MM)细胞的免疫表型特征及稳定性。方法:用四色流式细胞术检测28例MM患者恶性浆细胞表面免疫表型,并对其中12例MM初诊患者在2～4m非单抗治疗后重复检测免疫表型。结果:与正常浆细胞不同,多数MM恶性浆细胞异常表达CD56(89.3%)、CD117(50.0%)、CD28(25%)、CD20(14.3%),不表达CD19(96.4%),近一半的患者不表达CD27(42.8%);恶性浆细胞表面免疫表型不稳定,12例初诊患者中有5例(41.67%)患者化疗后抗原表达有改变;CD38++CD45dim～-CD19-CD56+表型的恶性浆细胞所占圈定浆细胞百分率(NP)与骨髓形态学检测瘤细胞负荷有很强的正相关性(γ=0.675,P<0.01),并且可以区分稳定期和进展期患者(P<0.05)。结论:恶性浆细胞表面异常表达CD56,不表达CD19,部分表达CD117、CD28、CD20,近一半患者CD27表达缺失。部分初诊患者非单抗治疗后,恶性浆细胞表面抗原表达发生变化。NP可以稳定区分稳定期和进展期患者,是衡量病情的新指标。更多还原

【Abstract】 Objective:This study was purposed to investigate the immunophenotype characteristics in multiple myeloma(MM) cells and their stability.Method:BM aspirate samples from 28 newly diagnosed MM patients and 12 patients of them after treatment were assessed using 4 color flow cytometric analyses.The plasma cells(PCs) were identified by their characteristic light scatter distribution and reactivity patterns to CD138,CD38,and CD45.Result:Moderate to bright expression of CD56,CD117,CD28,and CD20 was detected in 89.3%,50.0%,25%,and 14.3% myeloma cells respectively.CD19 was negative in 96.4% cases and nearly half were CD27 negative.Neoplastic plasma cells immunophenotype was unstable.Of 12 newly diagnosed patients,5(41.67%) showed immunophenotype change.The percentage of CD38++CD45dim～-CD19-CD56+ neoplastic plasma cells in gated plasma cells(NP) has a significant positive correlation with tumor burden judged by conventional morphology(γ=0.675,P<0.01),and the stability and progress of the patients can be distinguished by the percentage.Conclusion:The myeloma cells mainly express CD56,while the expressions of CD117,CD20,CD27 were seen in some MM patients.Myeloma cells don’t express B lymphocytes antigen CD19,which suggest the heterogenicity of multiple antigens expressed by myeloma cells.Immunophenotype′s change were found in 5 patients of 12 newly diagnosed MM patients after treatment.Recognition of the lackness of stability in immunophenotype may be important,especially in antigen targeted treatment or when specific phenotypes are used to detect residual disease.NP can distinguish patients in stable stage from progressive stage and is a new index to evaluate the disease.更多还原