[初诊多发性骨髓瘤患者CD56和CD19的表达及其与核型和预后的关系]

[Expression of CD56 and CD19 in Patients with Newly Diagnosed Multiple Myeloma and Their Relationship with Karyotypes and Prognosis].

作者信息

Qiu Quan, Zhu Ping, Wang Mang-Ju, Lu Xu-Zhen, Dong Yu-Jun, Sun Yu-Hua, Wang Li-Hong, Zhang Ying, Bu Ding-Fang, Wang Wen-Sheng, Liang Ze-Yin, Liu Wei, Qiu Zhi-Xiang, Ou Jin-Ping, Cen Xi-Nan

机构信息

Department of Hematology,Peking University First Hospital, Beijing 100034, China.

Department of Hematology,Peking University First Hospital, Beijing 100034, China. E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2016 Aug;24(4):1071-8. doi: 10.7534/j.issn.1009-2137.2016.04.021.

DOI:10.7534/j.issn.1009-2137.2016.04.021

PMID:27531777

Abstract

OBJECTIVE

To study the relationship between surface markers of CD56 and CD19 and karyotypes and prognosis in multiple myeloma.

METHODS

A total of 126 cases of newly diagnosed multiple myeloma in the first hospital of Peking university from 2011 to 2015 were enrolled in this study. Cytogenetic abnormalities and immunophenotypes were detected by using fluorescence in situ hybridization and flow cytometry respectively before chemotherapy. Bone marrow smear was used for detection of abnormal plasma cell infiltration. By combining with their basic data, the relationship between immunophenotypes, cytogenetics and prognosis of MM was analyzed.

RESULTS

(1) The median of myeloma cells in the 126 patients was 0.24（0.01-0.97）; the median of myeloma cells in 116 patients who have immunophenotype datas was 0.25（0.01-0.97）； the median of myeloma cells in CD19 positive patients was 0.11（0.01-0.53）; the median of myeloma cells in CD19 negative patients was 0.26（0.01-0.97）. The median of myeloma cells in CD19 positive patients was much lower than that in CD19 negative patients（P=0.036）. (2)In 116 patients detected by the immunophenotype, the myeloma cells expressed CD19,CD20,CD56 and CD117. Compared with CD56 negative patients(45/116,38.79%),CD56 positive patients(71/116,61.21%) had a clearly favorable disease outcome（OS was 53.0 month vs 31.0 month,P=0.016; PFS was 37.5 months vs 18.4 months, P=0.036）. (3)CD19 positive patients was 16.38%（19/116）,CD19 negative patients was 83.62%（97/116）； CD19 positive MM and CD19 negative MM had no difference in OS and PFS. (4)CD117 positive rate in CD19 positive patients was 42.11%(8/19), the CD117 positive rate in CD19 negative patients was 18.57%(18/97), the CD19 expression positively correlated with CD117 expression. (5)FISH detection was done for 67 newly diagnosed MM patients, 8 patients showed normal karyotypes(11.94%), 59 patients had abnormal karyotypes(88.06%). The most common abnormal karyotypes were IgH rearragement which occurred in 47 patients(70.15%). Other abnormal karyotypes included 1q21+, del(13q14),del(13q14.3),del(17p13) . These abnormal karyotypes occurred in 37 patients（55.22%）,31 patients（46.27%）,33 patients（49.25%） and 13 patients（19.40%） respectively. In comparison with CD19 negative MM patients, the incidence rate of 1q21+ and del(13q14.3) was significantly lower in CD19 positive patients(1q21+:33.33% vs 61.54%,P=0.016; del(13q14.3): 33.33% vs 53.85%,P=0.043）.

CONCLUSION

The prognosis of CD56 positive MM patients is better than that of CD56 negative MM patients, CD19 negative MM has more abnormal karyotypes and bone marrow infiltration,but they have no statistical prognostic differences.

摘要

目的

研究多发性骨髓瘤中CD56和CD19表面标志物与核型及预后的关系。

方法

选取2011年至2015年北京大学第一医院新诊断的126例多发性骨髓瘤患者纳入本研究。化疗前分别采用荧光原位杂交和流式细胞术检测细胞遗传学异常和免疫表型。骨髓涂片用于检测异常浆细胞浸润。结合患者基本资料，分析MM免疫表型、细胞遗传学与预后的关系。

结果

（1）126例患者骨髓瘤细胞中位数为0.24（0.01 - 0.97）；有免疫表型数据的116例患者骨髓瘤细胞中位数为0.25（0.01 - 0.97）；CD19阳性患者骨髓瘤细胞中位数为0.11（0.01 - 0.53）；CD19阴性患者骨髓瘤细胞中位数为0.26（0.01 - 0.97）。CD19阳性患者骨髓瘤细胞中位数明显低于CD阴性患者（P = 0.036）。（2）在116例经免疫表型检测的患者中，骨髓瘤细胞表达CD19、CD20、CD56和CD117。与CD56阴性患者（45/116，38.79%）相比，CD56阳性患者（71/116，61.21%）疾病转归明显较好（总生存期为53.0个月对31.0个月，P = 0.016；无进展生存期为37.5个月对18.4个月，P = 0.036）。（3）CD19阳性患者占16.38%（19/116），CD19阴性患者占83.62%（97/116）；CD19阳性MM和CD19阴性MM在总生存期和无进展生存期方面无差异。（4）CD19阳性患者中CD117阳性率为42.11%（8/19），CD19阴性患者中CD117阳性率为18.57%（18/97），CD19表达与CD117表达呈正相关。（5）对67例新诊断的MM患者进行FISH检测，8例核型正常（11.94%），59例核型异常（88.06%）。最常见的异常核型是IgH重排，发生在47例患者中（70.15%）。其他异常核型包括1q21 +、del(13q14)、del(13q14.3)、del(17p13)。这些异常核型分别发生在37例（55.22%）、31例（46.27%）、33例（49.25%）和13例（19.40%）患者中。与CD19阴性MM患者相比，CD19阳性患者中1q21 +和del(13q14.3)的发生率明显较低（1q21 +：33.33%对61.54%，P = 0.016；del(13q14.3)：33.33%对53.85%，P = 0.043）。