论文部分内容阅读
目的分析多发性骨髓瘤(MM)细胞遗传学变化以及它与MM的分型、分期及其他预后指标的关系,探讨其临床意义。方法采用骨髓细胞24 h短期培养法及R显带技术,对20例MM患者骨髓细胞进行染色体核型分析,并与MM的分型、分期及预后因素进行相应的分析。结果20例MM患者中,发现染色体核型异常者8例(40%),其中5例数目异常,表现为亚二倍体、超二倍体、四倍体;8例均有结构异常,包括易位、增加和丢失等;发生于MMⅢ期7例(35%),MMⅠ期1例(5%);IgG型6例(30%),IgA型1例,轻链型1例。有异常核型的MM患者表现为血沉加快、高钙血症、低血小板、高β2微球蛋白(β2-MG)、高C反应蛋白(CRP)、低血红蛋白(Hb)、原浆细胞比例增高、高乳酸脱氢酶(LDH),其中Hb、β2-MG、CRP、LDH、原浆细胞比例与无核型改变的MM比较,差异均有统计学意义(均P<0.05)。结论存在染色体异常的MM患者多发生于Ⅲ期,与分型无关,而与临床分期及病情的进展有关,且预后差。
Objective To analyze the cytogenetic changes of multiple myeloma (MM) and its relationship with the classification, staging and other prognostic factors of MM, and to explore its clinical significance. Methods Chondrocyte karyotype analysis was performed on bone marrow cells from 20 patients with MM by 24 h short-term culture of bone marrow cells and R-banding technique. The genotyping, stage and prognostic factors of MM were analyzed. Results Eighty patients (40%) with chromosomal abnormalities were found in 20 patients with MM, of which 5 were abnormal and showed sub-diploid, diploid and tetraploidy. All of the 8 patients had structural abnormalities including (35%) occurred in MM stage, 1 case (5%) in MM stage Ⅰ, 6 cases (30%) of IgG type, 1 case of IgA and 1 case of light chain. MM patients with abnormal karyotype showed elevated ESR, hypercalcemia, low platelet, high β2-MG, high CRP, Hb and increased proportion of plasma cells , And lactate dehydrogenase (LDH). There was significant difference between Hb, β2-MG, CRP, LDH, plasma cells and non-karyotype MM (all P <0.05). Conclusion MM patients with chromosomal abnormalities mostly occur in stage Ⅲ, which has nothing to do with the typing, but related to the clinical stage and progression of the disease, and the prognosis is poor.