CD138免疫磁珠细胞分选的FISH技术在多发性骨髓瘤诊断中的应用

为了分析CD138免疫磁珠细胞分选的染色体荧光原位杂交(FISH)技术在提高多发性骨髓瘤(MM)细胞遗传学异常检测敏感性的作用。本研究选取我院收治的30例确诊MM的患者为研究对象,分离骨髓单个核细胞,应用探针组合,同时采用2种方法进行细胞遗传学检测:实验组采用CD138免疫磁珠分选浆细胞后行荧光原位杂交技术(MACS-FISH)检测;对照组直接荧光原位杂交技术(D-FISH)检测。结果:30例MM患者,实验组采用CD138 MACS-FISH检出率为83.3%,对照组D-FISH法细胞遗传异常检出率为46.7%,两组差异具有统计学意义(p<0.05)。研究结果表明:分析不同类型的细胞遗传异常,MACS-FISH法1q21检出率为46.7%,RB1检出率为50.0%,Ig H检出率为70.0%,P53检出率为20.0%;D-FISH法检出率分别为23.3%,30.0%、36.7%、10.0%。通过细胞核型分析,30例MM患者中,发现5例患者为异常核型,仅为16.7%,其中1例患者为单一结构异常,复杂异常核型患者为4例。我们的研究结论表明:进行CD138免疫磁珠分选浆细胞的FISH技术在多发性骨髓瘤诊断应用中可显著提高细胞遗传学异常检测敏感性,具有临床推广应用的价值。

Application of FISH Technique in the Diagnosis of Multiple Myeloma by CD138 Immunomagnetizing Beads

To investigate the value of CD138 immunomagnetic sorting combined with FISH for the cytogenetic detection of multiple myeloma(MM).A total of 30 patients with MM in our hospital were enrolled in this study.The cytogenetic abnormalities in the patients with multiple myeloma were detected by direct fluorescence in situ hybridization(D-FISH)and immunomagnetic sorting myeloma cells fluorescence in situ hybridization(MACS-FISH)using 4 probes,including lq21,RB1,Ig H,and P53.Clonal aberrations were detected in 25 cases(83.3%)and 14 cases(46.7%)bv MACS-FISH and D-FISH respectively,shown significant differences between the two groups(p<0.05).The detection frequencies of clonal aberrations for 1q2 l amplification,RB1 deletion,Ig H rearrangement and P53 deletion by MACS-FISH were 46.7%,50.0%,70.0%and 20.0%respectively,compared with 23.3%,30.0%,36.7%and 10.0%respectively by D-FISH.Analysis of karyotyping revealed that there are cytogenetic abnormalities in 5 cases(16.7%),of which 1 case was single structural abnormalities and 4 cases were complex abnormal karyotype.CD138 MACS-FISH can significantly improve the dete ction efficiency of cytogenetic abnormalities in patients with MM and has important clinical value in cytogenetic detection of MM.