Sonneveld P, Durie B G, Lokhorst H M, Frutiger Y, Schoester M, Vela E E
Erasmus University, Department of Haematology, Rotterdam, The Netherlands.
Br J Haematol. 1993 Jan;83(1):63-7. doi: 10.1111/j.1365-2141.1993.tb04632.x.
Monoclonal gammopathy of undetermined significance (MGUS) is different from multiple myeloma (MM) by a low proliferation and by its indolent clinical course. In this study, two biological parameters were investigated which mark the transition from MGUS to MM, i.e. expression of the P-170 glycoprotein associated with the multidrug resistance phenotype (MDR-1) and expression of the natural killer cell antigen. CD56. Strong MDR-1 expression was found in plasma cells of 32/38 untreated MGUS as compared with 33/105 untreated MM stage I-III (84% v 32%, P < 0.001) and in 0/10 normal plasma cell samples. CD56 expression in high density was present in 43/57 analysed untreated MM but in none of 23 MGUS (78% v 0%, P < 0.0001). Plasma cells did characteristically show a low Ki-67 proliferation index in 14/15 MGUS patients (mean 0.05%, range 0-0.2%) and a higher index in 25 analysed MM patients (mean 2.31%, range 1-7%, P < 0.03). These data indicate that MDR-1 expression together with absence of CD56 expression and a low proliferation index can be used to separate MGUS from MM.
意义未明的单克隆丙种球蛋白病（MGUS）与多发性骨髓瘤（MM）不同，其增殖水平较低，临床病程呈惰性。在本研究中，对两个标志着MGUS向MM转变的生物学参数进行了研究，即与多药耐药表型（MDR-1）相关的P-170糖蛋白的表达以及自然杀伤细胞抗原CD56的表达。在32/38例未经治疗的MGUS浆细胞中发现了强MDR-1表达，相比之下，在33/105例未经治疗的MM I-III期患者中该表达率为84%对32%（P<0.001），而在10例正常浆细胞样本中未发现。高密度CD56表达出现在43/57例分析的未经治疗的MM中，但在23例MGUS中均未出现（78%对0%，P<0.0001）。在14/15例MGUS患者中，浆细胞特征性地显示Ki-67增殖指数较低（平均0.05%，范围0-0.2%），而在25例分析的MM患者中该指数较高（平均2.31%，范围1-7%，P<0.03）。这些数据表明，MDR-1表达、CD56表达缺失以及低增殖指数可用于区分MGUS和MM。
