多发性骨髓瘤患者外周血与骨髓中瘤细胞的检测及临床意义

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1、多发性骨髓瘤患者外周血与骨髓中瘤细胞的检测及临床意义作者：蒋元强，李建勇，吴雨洁，杨慧，沈云峰，陈丽娟，徐卫，钱思轩，吴汉新，陆化，盛瑞兰【摘要】本研究探讨多发性骨髓瘤（MM）患者的循环骨髓瘤细胞（circulatingmyelomacells,CMC）和骨髓骨髓瘤细胞(marrowmyelomacells,MMC)的相关性及其临床意义。采用四色流式细胞术对55例MM患者同时检测CMC和MMC的百分率，并结合患者的β2微球蛋白（β2-MG）、血浆白蛋白（Alb）水平、染色体核型、肾功能等预后相关指标进行系统分析。将患者分成4组：A组为同时检测到C

2、MC和MMC患者；B组为仅检测到MMC患者；C组为仅检测到CMC患者；D组为未检测到瘤细胞患者。结果发现：与其他各组相比，A组的β2-MG和肌酐浓度显著增高，白蛋白水平明显低下。就上述预后因素而言，在检测到与未检测到骨髓瘤细胞患者之间，差异有统计学意义。初发、复发/难治患者的CMC和MMC百分率明显高于部分缓解和完全缓解的患者。骨髓瘤患者CMC与MMC显著相关。结论：骨髓瘤患者CMC和MMC百分率不仅反映肿瘤负荷，而且预示病情进展，特别是同时检测到CMC和MMC的多发性骨髓瘤患者。【关键词】14多发性骨髓瘤；骨髓瘤细胞；循环骨髓瘤细胞；骨髓骨髓瘤

3、细胞　　DetectionofCirculatingandBoneMarrowMyelomaCellsinPatientswithMultipleMyelomaandItsClinicalSignificance　　AbstractThisstudywasaimedtoinvestigatethecorrelationbetweencirculatingmyelomacells(CMC)andbonemarrowmyelomacells(MMC)inpatientswithmultiplemyeloma(MM)anditsclinicalsign

4、ificance.Four-colorflowcytometrywasusedtodetectthepercentageofCMCandMMCin55patientswithMM.Otherprognosis-associatedfactorssuchasβ2microglobulin(β2-MG),serumalbumin(Alb),chromosomalabnormalitiesandrenalfunctionweresimultaneouslyanalyzed.Thepatientsweredividedintofourgroups:gro

5、upA,inwhichCMCandMMCweresimultaneouslydetected;groupB,inwhichonlyMMCweredetected;groupC,inwhichonlyCMCweredetected;groupD,inwhichnomyelomacellsweredetectedinperipheralbloodorbonemarrow.Theresultsshowedthattheconcentrationsofβ2-MGandcreatinineweresignificantlyincreasedandAlbma

6、rkedlydecreasedingroupAascomparedwithothergroups.Statisticaldifferencesexistedintheabove-mentionedfactorsbetweenpatientswithmyelomacellsdetectedandnotdetected.14ThepercentagesofCMCorMMCinnewlydiagnosed,refractoryandrelapsedpatientswereapparentlyhigherthanthoseinpatientswithpa

7、rtialandcompleteremission,respectively.CMCwerestrikinglycorrelatedwithMMC.ItisconcludedthatthepercentagesofCMCandMMCnotonlyimplytumorloadinMMpatients,butalsopredicttheprogressionofMM,espectivelyforpatientswithMM,inthosepatientsCMCandMMCweresimultaneouslydetected.　　Keywordsmul

8、tiplemyeloma;myelomacell;circulatingmyelomacell;bonemarrwmyelomacell