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.doc

多发性骨髓瘤患者外周血与骨髓中瘤细胞 hi 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患者的循环骨髓瘤 细胞和骨髓骨髓瘤细胞(marrowmye 1 omacells,M MC)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B 2微球蛋白、血 浆白蛋白水平、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CMC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B2-MG和肌軒浓度显著增高，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MM C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】 多发性骨髓瘤；骨髓瘤细胞；循环骨髓瘤 细胞；骨髓骨髓瘤细胞 Detection ofCirculatingandBo neMarrowMye1omaCe1 lsinPati entswithMu sClinicalSignifica neeAbstractThisst stigatethecorrelat ingmyelomacells(CM lomacells(MMC) inp emye1oma(MM)andits ce.Four lsinPati entswithMu sClinicalSignifica neeAbstractThisst stigatethecorrelat ingmyelomacells(CM lomacells(MMC) inp emye1oma(MM)andits ce.Four-colorflowc etectthepercentage ltipleMye1omaandltudywasaimed toinve ionbetweencirculat C)andbonemarrowmye atientswithmultipl clinicalsignifican ytometrywasusedtod ofCMCandMMCin55pat ientswithMM. Otherp rognosis-associate dfactorssuchas B 2mi croglobulin( B 2~MG) ,serumalbumin(Alb) 2~MG) ,serumalbumin(Alb)alitiesandrenalfun ouslyanalyzed? Thep intofouTgroups：gro MMCweresimultaneou slydetected；groupB edetected；groupC,i etected；groupD,inw weredetectedinperi arrow. Theresultssh ,chromo s oma1abnorm c t i o nwe r e s i muIt ane atientsweredivided upA,inwhich CMCand,i nwh i chon1yMMCwer nwhichonlyCMCwered hi chnomye1omacells pheralbloodorbonem rationsof B owedthattheconcent ndAlbmarkedlydecre aredwithothergroup rencesexistedinthe torsbetweenpatient etectedandnotdetec ofCMCorMMCinnewlyd yandrelapsedpatien gherthanthoseinpat dcompleteremission erestTikinglycorre concludedthat thep MMCnotonlyimplytum orloadinMMpatients progre s s i onofMM,es tswithMM,inthosepaasedingroupAascomp s. Statisticaldiffe above ndAlbmarkedlydecre aredwithothergroup rencesexistedinthe torsbetweenpatient etectedandnotdetec ofCMCorMMCinnewlyd yandrelapse