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目的探讨多发性骨髓瘤(MM)患者MICM分型的特征及应用价值。方法对19例初发多发性骨髓瘤患者的MICM进行回顾性分析。结果骨髓形态学显示,幼稚+成熟浆细胞比例为2.5%~75.5%;多参数流式分析异常浆细胞比例为1.4%~32.8%。抗原阳性表达比例分别为CD138 100%,CD38 100%,CD56 63.1%,CD117 42.1%,CD130%,CD33 26.3%,CD20 5.2%,CD22 0%,CD10 0%,CD19 0%。免疫球蛋白胞浆限制性表达,其中Cκ9例,Cλ10例。免疫固定电泳显示Ig G+κ型4例,Ig A+κ型2例,Ig G+λ型4例,Ig A+λ型1例,。Ig基因重排分析IGH FR1-JH重排阳性者8例,IGH FR2-JH重排阳性者11例,IGH DH-JH重排阳性者2例,IGK Vk-Jk重排阳性者11例,IGK Vk-Kde+intron-Kde重排阳性者8例。结论 MICM分型,对患者治疗方案选择及预后的判断均具有临床价值。
Objective To investigate the characteristics and clinical value of MICM typing in patients with multiple myeloma (MM). Methods The MICM of 19 patients with newly diagnosed multiple myeloma was analyzed retrospectively. Results The bone marrow morphology showed that the ratio of naive + mature plasma cells was 2.5% -75.5%. The multi-parameter flow cytometry analysis showed that the proportion of abnormal plasma cells was 1.4% -32.8%. The positive expression rates of antigen were 100% for CD138, 100% for CD38, 63.1% for CD56, 42.1% for CD117, 26.3% for CD137, 5.2% for CD20, 0% for CD22, 0% for CD10 and 0% for CD19. Immunoglobulin cytoplasm restricted expression, including Ck9 cases, Cλ10 cases. Immune fixed electrophoresis showed that Ig G + κ type 4 cases, Ig A + κ type 2 cases, Ig G + λ type 4 cases, Ig A + λ type 1 case. Ig gene rearrangement analysis of IGH FR1-JH rearrangements in 8 cases, IGH FR2-JH rearrangements in 11 cases, IGH DH-JH rearrangements in 2 cases, IGK Vk-Jk rearrangements in 11 cases, IGK Vk-Kde + intron-Kde rearrangements in 8 cases. Conclusion The classification of MICM has clinical value in the selection of patients’ treatment options and prognosis.