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中国生物工程杂志

China Biotechnology
China Biotechnology
China Biotechnology  2023, Vol. 43 Issue (12): 78-85    DOI: 10.13523/j.cb.2310067
    
The Clinical Application Value of Immunophenotype Analysis by Flow Cytometry in the Diagnosis and Treatment of Multiple Myeloma
YANG Zhi-hong1,**(),ZHANG Ya-qi2,BAI Yong-ze1,TANG Xiu-ying1,ZHANG Yu-ying1,LI Xia1
1 The General Hospital of Ningxia Medical University, Yinchuan 750004, China
2 The First Clinical Medical School of Ningxia Medical University, Yinchuan 750004, China
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Abstract  

Objective: To explore the clinical significance of flow cytometry (FCM) immunophenotype analysis in the diagnosis and treatment of multiple myeloma (MM). Methods: A total of 117 newly diagnosed MM patients admitted to the Hematology Department of Ningxia Medical University General Hospital from January 2019 to June 2023 were selected for immunophenotypic analysis using flow cytometry with polychromatic fluorescent labeled antibodies. At the same time, bone marrow cell morphology, immunofixation electrophoresis (IFE), and quantitative immunoglobulin detection results were collected and analyzed. Results: 117 MM patients underwent gate analysis using CD45/SSC and CD45/CD38 dot maps. Abnormal cell populations were observed in areas with CD45 negative or weakly positive, CD38 strongly positive, and SSC larger than those with nuclear red blood cells, accounting for approximately 0.1% to 91.5% of nuclear cells. CD38 was strongly expressed in all 117 cases, CD138 in 111 cases, CD56 in 78 cases, CD229 in 67 cases, CD27 in 48 cases, CD200 in 44 cases, CD117 in 40 cases, CD269 in 30 cases, CD28 in 25 cases, CD20 in 19 cases, CD81 in 9 cases, CD13 in 7 cases, and CD19 in 4 cases and the positive expression rates were 100%, 94.87%, 66.67%, 57.26%, 41.03%, 37.61%, 34.19%, 25.64%, 21.37%, 16.24%, 7.69%, 5.98%, and 3.42%, respectively. All 117 cases were restrictedly expressed with cytoplasmic light chains (100%), of which 64 cases were restrictedly expressed with cKappa light chains (54.70%) and 53 cases with cLambda light chains (45.30%). Morphological examination of bone marrow cells revealed myeloma cells in 111 cases (94.87%) under microscope, and M protein was detected in 114 cases using IFE, with a detection rate of 97.44%. Conclusions: FCM immunophenotyping can accurately, quickly, and objectively distinguish between benign and malignant plasma cells, reveal the clonal expression of cytoplasmic light chain and the expression characteristics of CD molecules in myeloma cells, and provide objective basis for the early diagnosis, classification, prognosis evaluation, and treatment of MM. It has good clinical application value.

Key words： Flow cytometry      Multiple myeloma      Immunophenotype     
Received: 16 November 2023      Published: 16 January 2024
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Zhi-hong YANG
Ya-qi ZHANG
Yong-ze BAI
Xiu-ying TANG
Yu-ying ZHANG
Xia LI
Cite this article:

Zhi-hong YANG, Ya-qi ZHANG, Yong-ze BAI, Xiu-ying TANG, Yu-ying ZHANG, Xia LI. The Clinical Application Value of Immunophenotype Analysis by Flow Cytometry in the Diagnosis and Treatment of Multiple Myeloma. China Biotechnology, 2023, 43(12): 78-85.

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https://manu60.magtech.com.cn/biotech/10.13523/j.cb.2310067     OR     https://manu60.magtech.com.cn/biotech/Y2023/V43/I12/78

类型 M蛋白阳性
(114例 97.44%)		 M蛋白阴性
(3例 2.56%)
IgG IgA 游离轻链型 IgD IgE 不分泌型
κ型 33(28.95%) 13(11.40%) 14(12.28%) 1(0.88%) 1(0.88%) -
λ型 17(14.91%) 20(17.54%) 14(12.28%) 1(0.88%) 0 -
合计 50(43.86%) 33(28.94%) 28(24.56%) 2(1.76%) 1(0.88%) -
Table 1 IFE measurement results of 117 MM patients
类型 例数 IgG/(g/L) IgA/(g/L) IgM/(g/L) κ/(mg/L) λ/(mg/L) κ/λ值
IgG κ型 33 56.2±29.97↑ 0.50±0.52↓ 0.30±0.27↓ 13 489.39±11 057.03↑ 406.53±397.52↓ 115.41±211.83↑
λ型 17 74.1±43.98↑ 0.30±0.13↓ 0.21±0.07↓ 392.30±444.50↓ 17 310.00±7 357.22↑ 0.09±0.22↓
IgA κ型 13 4.72±2.37↓ 26.28±27.06↑ 0.40±0.49 5 248.46±2 995.58↑ 596.85±320.82↓ 11.52±8.27↑
λ型 20 7.09±13.07 38.10±26.68↑ 0.22±0.09↓ 1 071.95±628.10↓ 7 344.50±4 980.57↑ 0.28±0.39↓
IgD κ型 1 3.79↓ 0.37↓ 0.18↓ 4 570.00↑ 294.00↓ 15.54↑
λ型 1 4.08↓ 0.28↓ 0.18↓ 278.00↓ 2 010.00↓ 0.36↓
IgE κ型 1 4.49↓ 0.27↓ 0.18↓ 6 800.00↑ 443.00↓ 15.35↑
κ轻链型 14 6.05±1.84↓ 0.38±0.17↓ 0.20±0.84↓ 2 850.00±1 472.83 640.35±278.40↓ 42.32±142.84↑
λ轻链型 14 5.32±2.05↓ 0.51±0.33↓ 0.21±0.61↓ 1 083.79±459.45↓ 2 383.43±1 586.26↑ 0.61±0.36↓
不分泌型 3 7.43±1.60 0.88±0.65 0.39±0.36↓ 1 660.00±770.78↓ 849.33±263.75↓ 1.90±0.30
生物参考区间 7~16 0.7~4 0.4~2.3 1 700~3 700 900~2 100 1.35~2.65
Table 2 Quantitative detection results serum globulin and serum light chain κ、λ in 117 MM patients with different subtypes ( x - ± s)
CD抗原
系列		 CD抗原表达情况
强阳性例数 阳性例数 弱阳性例数 部分表达例数 少数表达例数
cKappa 0 64(54.70) 0 0 0
cLambda 0 53(45.30) 0 0 0
CD45 0 0 29(24.79) 0 0
CD38 117(100) 0 0 0 0
CD138 0 97(82.91) 0 13(11.11) 1(0.85)
CD56 0 66(56.40) 0 12(10.26) 0
CD19 0 1(0.85) 0 3(2.56) 0
CD20 0 11(9.40) 0 8(6.84) 0
CD27 0 41(35.40) 0 6(5.13) 1(0.85)
CD200 0 35(29.91) 0 9(7.69) 0
CD229 0 63(53.85) 0 4(3.42) 0
CD269 0 20(17.09) 0 10(8.55) 0
CD28 0 16(13.68) 0 9(7.69) 0
CD117 0 29(24.79) 0 11(9.40) 0
CD81 0 3(2.56) 0 6(5.13) 0
CD13 0 0 0 7(5.98) 0
Table 3 Number and percentage of CD antigen expression in 117 MM patients
CD抗原系列 Ig亚型(n)
IgG(50) IgA(33) 轻链κ型(14) 轻链λ型(14)
CD45 12(24.00) 10(30.30) 3(24.43) 2(14.29)
CD38 50(100.00) 33(100.00) 14(100.00) 14(100.00)
CD138 47(94.00) 30(90.90) 14(100.00) 14(100.00)
CD56 36(72.00)* 27(81.81)* 9(64.29)* 4(28.57)*
CD19 1(2.00) 1(3.03) 1(7.14) 1(7.14)
CD20 6(12.00) 5(15.15) 4(28.57) 2(14.29)
CD27 22(44.00) 11(33.33) 8(57.14) 6(42.86)
CD200 25(50.00) 10(30.30) 4(28.57) 2(14.29)
CD229 31(62.00) 16(48.48) 7(50.00) 8(57.14)
CD269 16(32.00) 6(18.18) 3(21.42) 3(24.43)
CD28 11(22.00) 10(30.30) 0 4(28.57)
CD117 18(36.00) 14(42.42) 4(28.57) 3(24.43)
CD81 5(10.00) 2(6.06) 0 2(14.29)
CD13 0 4(12.12) 0 2(14.29)
Table 4 Immunophenotypic CD antigen positive expression results in patients with different types of immunoglobulin MM[n(%)]
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