三种实验技术在多发性骨髓瘤检测中的应用
发布时间：2018-10-15 17:26
【摘要】：背景多发性骨髓瘤(Multiple myeloma, MM)是以B细胞起源,骨髓中恶性浆细胞(瘤细胞)异常增生和聚集为特征的一种衰竭性、难以治愈的恶性肿瘤,并伴有单克隆免疫球蛋白或其成分(M蛋白)增多。由于在疾病早期,其临床表现无特异性,极易出现误诊和漏诊。本试验通过免疫细胞化学、流式细胞术对传统骨髓细胞形态学诊断的50例MM进行细胞免疫表型分析,并比较三种检测方法之间的差异,以期为MM的早期诊断及疗效判断提供更可靠的检测方法。目的探讨骨髓细胞形态学、免疫细胞化学和流式细胞术在MM检测中的应用价值。方法1采用瑞氏染色,对50例MM患者骨髓标本进行形态学观察；2分别采用流式细胞术、免疫细胞化学方法检测50例MM患者骨髓瘤细胞的免疫表型,分析其表达率；3比较三种检测技术在MM检测中的应用价值。结果1形态学检测结果：50例患者骨髓细胞形态学结果主要为骨髓瘤细胞增生,并伴有质的改变。形态学检查骨髓瘤细胞比例为6.0%-95.0%。2免疫细胞化学结果：50例MM患者CD138阳性表达率98.0%(49/50), Kappa阳性14例,Lambda阳性12例。3流式细胞术结果：对骨髓瘤细胞抗原CD38、CD138、CD19、CD56、CD45、 cKappa、cLambda进行分析,结果发现：50例MM中CD138、CD38阳性表达率均为100.00%(50/50),其他抗原表达阳性率由高到低分别为：CD5670.0%(35/50), CD1910.0%(5/50), CD454.0%(2/50)。Kappa轻链型占28.0%(14/50), Lambda轻链型占24.0%(12/50)。450例MM患者,形态学检测骨髓瘤细胞中位数比例为45.00%(6.00%-95.00%),免疫细胞化学检测中位数比例为37.25%(9.00%～88.00%),流式细胞术检测中位数比例为28.16%(4.07-87.42%)。550例MM患者免疫细胞化学结果阳性38例,阳性率为76.0%(38/50)。流式细胞术结果阳性37例,阳性率为74.0% (37/50),两种方法差异无统计学意义(X2=0.049,P0.05)。结论1免疫细胞化学与流式细胞术对MM确诊都有检测意义。2骨髓细胞形态学、免疫细胞化学及流式细胞术三种检测技术相结合,更有助于MM的诊断及鉴别诊断。
[Abstract]:Background multiple myeloma (Multiple myeloma, MM) is a failing and intractable malignant tumor characterized by the origin of B cells and the abnormal proliferation and aggregation of malignant plasma cells (tumor cells) in bone marrow. It was accompanied by an increase in monoclonal immunoglobulin or its component (M protein). Due to the lack of specificity in the early stage of the disease, misdiagnosis and missed diagnosis are easy to occur. The immunophenotype of 50 cases of MM diagnosed by traditional bone marrow cell morphology was analyzed by immunocytochemistry and flow cytometry, and the differences among the three methods were compared. In order to provide a more reliable detection method for early diagnosis and curative effect judgment of MM. Objective to investigate the value of bone marrow cell morphology, immunocytochemistry and flow cytometry in the detection of MM. Methods 1Morphology of bone marrow specimens from 50 patients with MM were observed by Rayleigh staining, 2Immunophenotypes of myeloma cells from 50 patients with MM were detected by flow cytometry and immunocytochemistry, and the expression rate of myeloma cells was analyzed. 3 compare the application value of three detection techniques in MM detection. Results 1Morphologic examination: the morphologic results of bone marrow cells in 50 patients were mainly myeloma cell proliferation, accompanied by qualitative changes. The proportion of myeloma cells was 6.0- 95.0.2 immunocytochemical results: the positive expression rate of CD138 was 98.0% (49 / 50), Kappa in 14 cases, Lambda positive in 12 cases) in 50 patients with MM. The results showed that the positive rate of CD138,CD38 expression in 50 cases of MM was 100.00% (50 / 50). The positive rates of other antigens were: CD5670.0% (35 / 50), CD1910.0% (5 / 50), CD454.0% (2 / 50). Kappa light chain type) 28.0% (14 / 50), Lambda light chain type 24.0% (12 / 50). The median percentage of myeloma cells, immunocytochemistry and flow cytometry were 45.00% (6.00-95.00%), 37.25% (9.0088.00%) and 28.16% (4.07-87.42%), respectively. The positive rate of immunocytochemistry was 76.0% (38 / 50) in 550 patients with MM. The positive rate of flow cytometry was 74.0% (37 / 50), and there was no significant difference between the two methods (X2, 0.049, P0.05). Conclusion (1) Immunocytochemistry and flow cytometry are important for the diagnosis of MM. (2) the combination of bone marrow cell morphology, immunocytochemistry and flow cytometry is helpful to the diagnosis and differential diagnosis of MM.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R733.3
本文编号：2273269
[Abstract]:Background multiple myeloma (Multiple myeloma, MM) is a failing and intractable malignant tumor characterized by the origin of B cells and the abnormal proliferation and aggregation of malignant plasma cells (tumor cells) in bone marrow. It was accompanied by an increase in monoclonal immunoglobulin or its component (M protein). Due to the lack of specificity in the early stage of the disease, misdiagnosis and missed diagnosis are easy to occur. The immunophenotype of 50 cases of MM diagnosed by traditional bone marrow cell morphology was analyzed by immunocytochemistry and flow cytometry, and the differences among the three methods were compared. In order to provide a more reliable detection method for early diagnosis and curative effect judgment of MM. Objective to investigate the value of bone marrow cell morphology, immunocytochemistry and flow cytometry in the detection of MM. Methods 1Morphology of bone marrow specimens from 50 patients with MM were observed by Rayleigh staining, 2Immunophenotypes of myeloma cells from 50 patients with MM were detected by flow cytometry and immunocytochemistry, and the expression rate of myeloma cells was analyzed. 3 compare the application value of three detection techniques in MM detection. Results 1Morphologic examination: the morphologic results of bone marrow cells in 50 patients were mainly myeloma cell proliferation, accompanied by qualitative changes. The proportion of myeloma cells was 6.0- 95.0.2 immunocytochemical results: the positive expression rate of CD138 was 98.0% (49 / 50), Kappa in 14 cases, Lambda positive in 12 cases) in 50 patients with MM. The results showed that the positive rate of CD138,CD38 expression in 50 cases of MM was 100.00% (50 / 50). The positive rates of other antigens were: CD5670.0% (35 / 50), CD1910.0% (5 / 50), CD454.0% (2 / 50). Kappa light chain type) 28.0% (14 / 50), Lambda light chain type 24.0% (12 / 50). The median percentage of myeloma cells, immunocytochemistry and flow cytometry were 45.00% (6.00-95.00%), 37.25% (9.0088.00%) and 28.16% (4.07-87.42%), respectively. The positive rate of immunocytochemistry was 76.0% (38 / 50) in 550 patients with MM. The positive rate of flow cytometry was 74.0% (37 / 50), and there was no significant difference between the two methods (X2, 0.049, P0.05). Conclusion (1) Immunocytochemistry and flow cytometry are important for the diagnosis of MM. (2) the combination of bone marrow cell morphology, immunocytochemistry and flow cytometry is helpful to the diagnosis and differential diagnosis of MM.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R733.3
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