| 赵晓红,周仲昊,王 晨,陆时运,王 智.CD56和CD117浆细胞免疫表型与多发性骨髓瘤患者染色体核型和预后的研究[J].,2018,(3):519-523 |
| CD56和CD117浆细胞免疫表型与多发性骨髓瘤患者染色体核型和预后的研究 |
| Role of CD56 and CD117 Expression in Karyotype and Prognosis in Patients with Multiple Myeloma |
| 投稿时间：2017-09-21 修订日期：2017-10-17 |
| DOI：10.13241/j.cnki.pmb.2018.03.026 |
| 中文关键词: CD56 CD117 多发性骨髓瘤 免疫表型 染色体核型 预后 |
| 英文关键词: CD56 CD117 Multiple myeloma Immunophenotyped Karyotype Prognosis |
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| 中文摘要: |
| 摘要 目的：探讨CD56和CD117浆细胞免疫表型与多发性骨髓瘤患者染色体核型和预后的关系。方法：选取2011年1月至2017年3月我院收治的66例多发性骨髓瘤患者，均采用以硼替佐米为基础的VTD化疗方法。采集患者新鲜骨髓液，采用流式细胞术(FCM)和荧光原位杂交技术(FISH)检测浆细胞免疫表型和细胞染色体核型。分析浆细胞免疫表型与患者染色体核型和预后的关系。结果：66例患者浆细胞CD19+、CD20+、CD45+、CD56+、CD117+表达频率分别为7.6%(5/66)、18.2%(12/66)、45.5%(30/66)、66.7%(44/66)和40.9%(27/66)。20例行FISH检测的患者，18例(90.0%)核型异常，其中12例(66.7%) IgH重排，9例(50.0%) 1q21+扩增，8例(44.4%) del(13q14.3)缺失，10例(55.6%) del(13q14)缺失，3例(16.7%) del(17p)缺失。CD56+患者1q21+扩增和del(13q14.3)发生率显著低于CD56-患者(27.3% vs 85.7%，18.2% vs 85.7%，P＜0.05)。CD117+患者1q21+扩增和del(17p)发生率显著低于CD117-患者(12.5% vs 80.0%，12.5% vs 20.0%，P＜0.05)。CD56+患者的PFS和OS明显延长[23.4(2.0-91.4) 月vs 19.8(3.0-85.1) 月，34.5(8.9-96.5) 月 vs 30.1(6.7-84.3) 月，P＜0.05]。CD117+患者PFS和OS明显延长[22.9(1.0-94.3) 月 vs 20.3(2.0-84.3) 月，33.9(7.4-93.5) 月vs 31.4(6.7-89.7) 月，P＜0.05]。Kaplan-Meier分析CD56和CD117阳性与阴性患者的PFS曲线和OS曲线存在显著性差异(P＜0.05)。结论：CD56+和CD117+患者的预后明显优于CD56-和CD117-患者，CD56-和CD117-患者染色体异常核型的发生率明显增加。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the expression of CD56 and CD117 in patients with multiple myeloma and their role in kary- otype and prognosis. Methods: A total of 66 patients with multiple myeloma treated in our hospital from January 2011 to March 2017 were selected as the subjects. All patients were treated with VTD chemotherapy. The fresh bone marrow of the patients was collected, and the plasma cell immunophenotype and cell karyotype were detected by flow cytometry (FCM) and fluorescence in situ hybridization (FISH). The relationship between plasma cell immunophenotype and karyotype and prognosis were analyzed. Results: The antigen posi- tive expression rate of myelomacells was as follows: CD19+ 7.6%(5/66), CD20+ 18.2%(12/66), CD45+ 45.5%(30/66), CD56+ 66.7%(44/66) and CD117+ 40.9%(27/66). 20 patients underwent FISH testing, 18 (90.0%) patients had abnormal karyotypes, IgH rearrange- ment occurred in 12 patients (66.7%), 1q21+ amplification occurred in 9 patients (50.0%), del (13q14.3) occurred in 8 patients (44.4%), del (13q14) occurred in 10 patients (55.6%), del (17p) occurred in 3 patients (16.7%). In comparison with CD56- patients, the incidence rate of 1q21+ and del (13q14.3) was significantly lower in CD56+ patients (27.3% vs 85.7%, 18.2% vs 85.7%, P＜0.05). In comparison with CD117- patients, the incidence rate of 1q21+ and del(17p) was significantly lower in CD117+ patients (12.5% vs 80.0%, 12.5% vs 20.0%, P＜0.05). In comparison with CD56- patients, the PFS and OS were significantly prolonged in CD56+ patients [23.4(2.0-91.4) month vs 19.8(3.0-85.1) month, 34.5(8.9-96.5) month vs 30.1(6.7-84.3) month, P＜0.05]. In comparison with CD117- patients, the PFS and OS were significantly prolonged in CD117+ patients [22.9(1.0-94.3) month vs 20.3(2.0-84.3) month, 33.9(7.4-93.5) month vs 31.4(6.7-89.7) month, P＜0.05]. Kaplan-Meier analysis showed that there were significant differences in PFS and OS curves between CD56 and CD117 positive and negative patients (P<0.05). Conclusion: The prognosis of patients with CD56+ and CD117+ was significantly better than that of CD56- and CD117- patients, and the incidence rate of abnormal karyotype of CD56- and CD117- patients increased significantly. |
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