摘要
目的探讨CD28和CD117在初诊多发性骨髓瘤(MM)患者中的表达及其临床意义。方法回顾性分析2015年5月至2017年12月郑州大学第一附属医院115例初诊MM患者,多参数流式细胞术检测CD28和CD117表达,并分析二者与MM分期及临床参数的关系,分期根据国际分期系统(ISS)进行。结果 115例患者中,CD117阳性15例,CD28阳性30例。CD117阳性表达与红细胞沉降率(r=-0.481,P=0.039)、C反应蛋白水平(r=-0.314,P=0.015)、骨髓细胞学测定的浆细胞比例(r=-0.027,P=0.001)呈负相关。CD28阳性表达与乳酸脱氢酶水平(r=0.249,P=0.033)、ISS分期(r=0.319,P=0.017)呈正相关,与血红蛋白水平(r=-0.372,P=0.026)呈负相关。CD28阳性与轻链类型有关,以不分泌型常见(P=0.016)。CD28阳性组和CD117阳性组中溶骨性病变发生率较高,但与CD28阴性组和CD117阴性组比较,差异均无统计学意义(P值分别为0.052、0.479)。结论早期MM患者中CD117阳性表达水平高于晚期患者,而CD28阳性表达水平在晚期患者中高于早期患者,CD28和CD117有望成为初诊MM患者预后分层的指标。
Objective To investigate the expressions of CD28 and CD117 in patients with newly diagnosed multiple myeloma (MM) and their clinical significances. Methods The clinical data of 115 newly diagnosed MM patients in the First Affiliated Hospital of Zhengzhou University from May 2015 to December 2017 were retrospectively analyzed. The expressions of CD28 and CD117 were detected by using multiparameter flow cytometry. The relationship between the expressions of CD28 and CD117 and MM staging and clinical parameters was analyzed. The staging was performed according to the International Staging System (ISS). Results Among these 115 patients, there were 15 patients with CD117 positive and 30 patients with CD28 positive. Erythrocyte sedimentation rate (r =-0.481, P = 0.039), C-reactive protein level (r =-0.314, P = 0.015), the proportion of plasma cells detected by bone marrow cytology (r =-0.027, P = 0.001) were negatively correlated with CD117 positive expressions. CD28 positive expression was positively correlated with lactate dehydrogenase level (r = 0.249, P = 0.033) and ISS stage (r = 0.319, P = 0.017), while it was negatively correlated with hemoglobin level (r =-0.372, P = 0.026). CD28 positive was associated with light chain type, and non-secretory type mostly occurred (P = 0.016). The incidence of osteolytic lesions in CD28 positive group and CD117 positive group was high, but there was no statistical difference between CD28 positive group, CD117 positive group and CD28 negative group, CD117 negative group (P = 0.052, P = 0.479). Conclusions The positive expression of CD117 in the early stage of MM patients is higher than that in the advanced stage, and the expression of CD28 positive in the advanced stage of MM patients is higher than that in the early stage. CD28 and CD117 can be used as indicators of prognosis stratification in the patients with newly diagnosed MM.
作者
葛芳芳
田文亮
孙慧敏
高风彩
孙慧
孙玲
郭荣
万鼎铭
刘林湘
刘延方
谢新生
姜中兴
Ge Fangfang;Tian Wenliang;Sun Huimin;Gao Fengcai;Sun Hui;Sun Ling;Guo Rong;Wan Dingming;Liu Linxiang;Liu Yanfang;Xie Xinsheng;Jiang Zhongxing(Department of Hematology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China)
出处
《白血病．淋巴瘤》
CAS
2019年第5期262-266,共5页
Journal of Leukemia & Lymphoma
