Zhao Xiaohui, Huang Qin, Slovak Marilyn, Weiss Lawrence
Department of Pathology, UCI Medical Center, Orange, CA 92868, USA.
Am J Clin Pathol. 2006 Jun;125(6):895-904. doi: 10.1309/B2P9-XEH4-4CY9-LPUK.
Morphologic determination of residual plasma cell myeloma is often difficult. This study was conducted to evaluate the diagnostic value of several ancillary methods. A total of 121 bone marrow specimens from patients with myeloma after bone marrow transplantation or chemotherapy were studied. Of those, 49 cases were studied by conventional cytogenetics (CC), 86 by flow cytometry (FC), 50 by immunohistochemical analysis, 72 by molecular studies (MS) for immunoglobulin gene rearrangements, and 18 by standard fluorescence in situ hybridization (FISH) study. Of the patients, 70 were found to have residual myeloma. Residual disease was detected in 58 of 70 patients by morphologic examination (detection rate, 83%), 25 of 26 by immunohistochemical analysis (96%), 39 of 54 by FC (72%), 6 of 40 by CC (15%), 6 of 12 by FISH (50%), and 24 of 40 by MS (60%). Among the ancillary studies, immunohistochemical analysis and FC were the most helpful ancillary studies for detection of residual disease in myeloma, with immunohistochemical analysis the most effective single method.
残留浆细胞骨髓瘤的形态学判定往往困难。本研究旨在评估几种辅助方法的诊断价值。共研究了121例骨髓移植或化疗后骨髓瘤患者的骨髓标本。其中，49例采用传统细胞遗传学（CC）研究，86例采用流式细胞术（FC），50例采用免疫组织化学分析，72例采用免疫球蛋白基因重排的分子研究（MS），18例采用标准荧光原位杂交（FISH）研究。这些患者中，70例被发现存在残留骨髓瘤。通过形态学检查在70例患者中的58例检测到残留疾病（检出率83%），免疫组织化学分析在26例中的25例（96%），FC在54例中的39例（72%），CC在40例中的6例（15%），FISH在12例中的6例（50%），MS在40例中的24例（60%）。在辅助研究中，免疫组织化学分析和FC是检测骨髓瘤残留疾病最有用的辅助研究，免疫组织化学分析是最有效的单一方法。
