Three Experimental Techniques Applied In The Detection Of Multiple Myeloma

Background Multiple myeloma (MM) is a malignant hematological disease. In the bone marrow the neoplastic plasma cells (myeloma cells) are malignant proliferation, leading to increased production of monoclonal immunoglobulin or its component (M protein). Since early in the disease, the clinical manifestations are nonspecific, so easily lead to misdiagnosed or never diagnosed. In 50 cases of MM which diagnosed by traditional bone marrow cell morphology, we used immunocytochemistry and flow cytometry to analyze immunophenotypes of myeloma cells. Then we compared the differences between these three kinds of detection methods, in order to provide a more reliable detection method for the early diagnosis and therapeutic evaluation of MM.Objective To assess the clinical value of bone marrow cell morphology immunocytochemistry and flow cytometry in the diagnosis of MM.Methods1 We used Wright’s stain to observe the morphologies of myeloma cells in 50 cases.2 We used flow cytometry and immunocytochemistry, respectively, to evaluate the immunophenotypes of myeloma cells.Results1 Morphological examination:The results of bone marrow cell morphology were mainly with abnormal plasma cell hyperplasia, and accompanied with qualitative changes. The morphology examination of the detection ratio of myeloma cells were 6.00%-95.00%.2 The results of immunocytochemistry:50 cases of MM patients with CD138 positive expression rate was 98.0%(49/50), Kappa was positive in 14 cases, Lambda was positive in 12 cases.3 The results of flow cytometry:We studied the antigens of myeloma cells, such as CD38, CD138, CD19, CD56, CD45, cKappa and cLambda. We found that, in 50 cases of MM, the positive expression rate of CD138 was 100%(50/50).The positive expression rate of CD38 was 100%(50/50), too.And the other antigens positive rates from high to low were:CD56 70.0%(35/50), CD19 10.0%(5/50), CD45 4.0%(2/50).Kappa light chain types accounted for 28.0%(14/50), and Lambda light types accounted for 34.0%(12/50).4 In the morphological examinations of 50 patients with MM, the median ratio of myeloma cells was 45.00%(6.00%～95.00%). The median ratio of immunocytochemistry detection was 37.25%(9.00%～88.00%).The median ratio of flow cytometry was 28.16% (4.07～87.42%).5 In the detection of immunocytochemistry, the positive results were in 38 cases, the positive rate was 76.0%(38/50). In the detection of flow cytometry, the positive results were in 37 cases, the positive rate was 74.0%(37/50).There was no statistically significant difference between these two methods (X2=0.049, P>0.05).Conclusion1 The immunocytochemistry and flow cytometry both had significance implications for the diagnosis of MM.2 The combination of three detection technologies was very helpful for both clinical diagnosis and differential diagnosis.