河北医科大学学报

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多发性骨髓瘤患者肿瘤细胞免疫表型特点及临床意义分析

  

  1. 河北医科大学第二医院血液科,河北 石家庄 050000
  • 出版日期:2018-07-25 发布日期:2018-07-04
  • 作者简介:滑欢(1987-),女,河北柏乡人,河北医科大学第二医院主治医师,医学硕士,从事血液科疾病诊治研究。

Characteristics and clinical significance of tumor cell immunophenotype in patients with multiple myeloma

  1. Department of Hematology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
  • Online:2018-07-25 Published:2018-07-04

摘要: [摘要]〓
〖HTH〗目的〖HTSS〗〖KG*2〗分析多发性骨髓瘤(multiple myeloma,MM)患者骨髓瘤细胞的免疫表型特点及其与临床分期、免疫球蛋白分型、预后的关系。
〖HTH〗方法〖HTSS〗〖KG*2〗回顾性分析血液科收治的初诊成人MM患者临床资料,对骨髓瘤细胞的免疫表型及其与MM分型、分期、年龄及预后关系等进行统计学分析。
〖HTH〗结果〖HTSS〗〖KG*2〗①不同免疫球蛋白类型的MM患者CD56阳性表达率不同(P<0.05),IgG型47.42%、IgA型25.77%、轻链型18.56%、IgD型8.25%。②骨髓瘤细胞免疫表型CD38、CD138、CD19、CD20、CD117阳性表达率在不同分期、不同年龄组及不同M蛋白类型之间无明显差别(P>005)。③CD56阳性MM患者3年OS、EFS率(60.7%、45.1%)均高于CD56阴性MM患者(25.2%、15.2%),差异有统计学意义(P<005);年龄>60岁组CD56阳性MM患者3年OS率(60.9%)高于CD56阴性MM患者(20.0%),差异有统计学意义(P<0.05);Ⅲ期CD56阳性MM患者3年OS率(48.3%)高于CD56阴性MM患者(18.3%),差异有统计学意义(P<0.05)。CD117阳性MM患者3年OS率、EFS率(65.2%、44.4%)均高于CD117阴性MM患者(25.3%、10.6%),差异有统计学意义(P<005)。
〖HTH〗结论〖HTSS〗〖KG*2〗①某些MM患者瘤细胞会有B细胞抗原表达,但在整个样本所占比重不大。②就CD56表达阳性率而言,IgG型最高;不同临床分期、不同年龄对骨髓瘤细胞免疫表型阳性表达率影响不大。③CD56阳性者预后良好,特别是对于老年患者或者临床分期较高的MM患者,CD56阳性是预后较好指标。④CD117阳性者生存率较高,预后良好。

关键词: 多发性骨髓瘤, 免疫表型分型, 预后

Abstract: [Abstract] Objective〖HTSS〗〓To analyze the immunophenotype of myeloma cells in patients with multiple myeloma (MM) and its relationship with clinical stage, immunoglobulin typing and prognosis.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A retrospective analysis of newly diagnosed adult MM patients, which were admitted to department of hematology in our hospital, and statistical analysis of the clinical characteristics of myeloma cell immunophenotype and MM typing, staging, age and prognosis etc were performed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓①The positive rate of CD56 expression in MM patients with different immunoglobulin types was different(P<0.05), IgG 47.42%, IgA 25.77%, light chain type 18.56%, IgD 8.25%. ②The positive rates of CD38, CD138, CD19, CD20 and CD117 in the immunophenotype of myeloma cells were not significantly different between different stages, different age groups and different M protein types(P>005). ③The 3 year OS rate and 3 year EFS rate of CD56+MM were 60.7% and 45.1%, respectively, and both were higher than CD56-MM(25.2%, 15.2%, P<005). The 3 years OS rate of CD56+MM in the over 60 years group was 60.9%, higher than CD56-MM (20.0%) (P<0.05). The 3 years OS rate of Ⅲ stage of was 48.3%, higher than CD56-MM(18.3%) (P<0.05). ④The 3 years OS rate and 3 years EFS rate of CD117+MM were 65.2% and 44.4%, respectively, and both were higher than CD117-MM(25.3%, 10.6%)(P<005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓①In some MM patients, tumor cells show B cell antigen expression, but not in the entire sample. ②As for the positive rate of CD56 expression, the IgG type was the highest; the clinical stage and the different age had little effect on the positive rate of the immunophenotype of myeloma cells. ③CD56+ has a good prognosis, especially for elderly patients or MM with higher clinical stage, and CD56+ is a better prognostic indicator. ④The survival rate of CD117+ patients is high, and the prognosis is good.

Key words: multiple myeloma, immunophenotyping; prognosis