摘要
目的:探讨CD27抗原在多发性骨髓瘤(multiple myeloma,MM)中的表达及其在临床诊断中的价值,以及CD27抗原与患者的临床特征及遗传学异常的相关性。方法:采用8色流式细胞术(FCM)检测123例M M患者骨髓细胞免疫表型,以51例正常的或反应性浆细胞增生患者作为对照。抗体组合包括ckappa-FITC/clambda-PE/CD38-ECD/CD45-PERCP/CD19-PC7/CD27-APC/CD138-BV421/CD56-BV510,采用CD138/CD38设门出浆细胞群后进一步分析CD56、CD19、ckappa、clambda以及CD45的表达,区分异常浆细胞和正常的或反应性浆细胞后,进一步分析CD27的表达率和平均荧光强度(mean fluorescence intensity,MFI),阳性率判断标准:≥20%为阳性。同时分析107例MM患者的实验室检查资料并采用荧光原位杂交(FISH)技术检测34例患者1q21扩增、13q14缺失、p53缺失、IGH重排,比较CD27^-M M患者与CD27^+M M患者的临床特征及遗传学异常特点。结果:MM患者中异常浆细胞的CD27^+率为48%(59/123),MFI为31.3±35.6;而正常的或反应性浆细胞CD27^+率为100%(51/51),MFI为93.7±6.3。MM患者中异常浆细胞CD27^+率及MFI明显低于正常的或浆细胞反应性增生的患者(P<0.001)。对58例CD27-和49例CD27^+M M患者进行实验室检查发现,反映疾病进展指标如血红蛋白、白蛋白、血清钙、血肌酐及预后相关因素β2-微球蛋白、LDH水平两组比较均无明显差异(P<0.05)。同时17例CD27-及17例CD27^+M M患者的1q21扩增、13q14缺失、p53缺失、IGH重排结果亦无显著差异(P<0.05)。结论:CD27^-或弱表达高度提示为MM。采用8色流式细胞术,能为良恶性浆细胞疾病的诊断和鉴别诊断提供可靠依据。
Objective： To explore the expression of CD27 antigen in patients with multiple myeloma（ MM）,and its clinical diagnostic value,as well as the correlation of CD27 with clinical features and genetic abnormalities. Methods：Using 8 color flow cytometry,the immunophenotype of 123 MM patients＇ marrow cells was examined,while 51 cases of normal plasma cell reactive prolieration were used as control. Antibodies are as follows： ckappa-FITC/clambda-PE/CD38-ECD/CD45-PERCP/CD19-PC7/CD27-APC/CD138-BV421/CD56-BV510. For differentiation of abnormal plasma cells from normal or reactive plasma cells,FS INT/FS PEAK with CD138/CD38 gating strategy was used to measure cell markers CD138,CD38,CD56,CD19,ckappa,clambda and CD45,then the expression rate of CD27 and mean fluorescence intensity（ MFI） were analyzed for its diagnostic value in MM. At the same time,the laboratory data of 107 cases of MM patients were analyzed and the fluorescence in situ hybridization（ FISH） was used to detecte 1q21 amplification,13q14 deletion,p53 deletion and IGH rearrangement in 34 cases,then the clinical features and genetic abnormalities were compared between CD27-and CD27 ＋ MM patients. Results： The CD27 positive rate of abnormal plasma cells in MM patients was 48%（ 59/123）（ percentage ≥20% as positive criterion）,MFI was 31. 3 ±35. 6; while the positive rate of normal or reactive plasma cells were 100%（ 51/51）,the MFI was 93. 7 ± 6. 3. The positive rate and MFI of CD27 in MM patients were significantly lower than that in normal or reactive plasma cells（ P〈0. 01）. Laboratory examination of 58 cases of CD27 negative and 49 cases of CD27 positive MM patients indicated that no significant differences were shown on disease progress parameter,such as hemoglobin,albumin,serum calcium,serum creatinine, and no notable differences were involved in the analysis of prognostic factors between the 2 groups,such as β2-MG microglobulin and LDH levels（ P〈0. 05）. The 1q21 amplification,13q14 deletion,p53 deletion,and I
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2017年第4期1069-1073,共5页
Journal of Experimental Hematology
基金
国家自然科学基金项目(81370656)
江苏省六大人才高峰项目(2014-WSN-009)
