| Objectives:(1)To study clinical significance,the expression and positive rate of CD138, CD38, CD56, CD19, CD20, CD200, CD28, CD86in plasma cells of patients with MM and normal plasma cells of controls. To learn the expression intensity of CD45between two different groups.(2) To study the relationship between the expression and positive rate of clusters of differentiation and the disease state of patients with Multiple Myeloma. To learn the relativity of the grouping and staging of MM with the clusters of differentiation expression.(3) To explore the interdependency among the expression of the clusters of differentiation and the level of β2-microglobulin, albumin, hemoglobin and serum creatinine in patients with MM.Methods:(1) Four-color flow cytometry (BD FACSCalibur)was respectively used to detect antigens expression rate of44diagnosed patients with MM and25normal controls(14patients with nutritional iron deficiency anemia and11healthy bone marrow donators). The antigens which were metioned above included CD138、CD38、CD56、 CD19、CD20、CD200、CD28、CD86. The results were analyzed by the software of Cell Quest and SPSS17.0. The positive expression rate of clusters of differentiation in cells surface is greater than twenty percent.(2) In two-parameter flow cytometry scatter plots,the definition of the negative expression of the fluorescence intensity of CD45was100～102, the weakly positive expression was102～103, and the strong positive expression was103～104.(3) The patients with MM were divided into three groups(newly diagnosed group, the remission group and unremission group) by the disease state. According to electrophoresis of serum immunoglobulin level, the patients were divided into the IgA、IgG and light chain immunoglobulin group. The patients were respectively split into three phases by the classification criteria of ISS and Durie-Salmon. The results were analysed by SPSS17.0.(4) The interdependency among the expression of the clusters of differentiation and the level of β2-microglobulin, albumin, hemoglobin and serum creatinine in patients with MM were analysed by SPSS17.0.Results:(1) The expression rate of clusters of differentiation among patients with MM are as fellows:CD138(84.88%±21.31%). CD38(98.22%±8.49%)、CD56(56.98%±42.79%)、CD19(13.23%±25.39%)、CD20(9.78%±22.75%)、CD200(62.42%±33.58%)、CD28(31.01%±35.63%)、CD86(34.27%±32.11%). The expression rate of clusters of differentiation among controls are CD138(85.50%±12.44%)、CD38(100%±0.00%)、CD56(3.87%±4.53%)、CD19(3.87%±4.53%)、CD20(3.66%±3.63%)、CD200(9.98%±5.24%)、CD28(6.35%±4.93%)、CD86(11.79%±18.57%)(2) The positive rate of clusters of differentiation among patients with MM are as fellows:CD138+(97.72%)、CD38+(100.00%)、CD56+(63.64%), CD19-(84.09%)、 CD20+(11.63%)、CD200+(77.27%)、CD28+(38.64%)、CD86+(54.55%). The positive rate of clusters of differentiation among controls are CD138+(100.00%)、CD38+(100.00%)、CD56-(0.00%)、CD19+(96.00%)、CD20-(0.00%)、CD200+(0%)、CD28+(0.00%)、CD86+(4.00%)(3) In patients with MM, the weakly positive expression rate of CD45is68.18%,both of the negative or strong expression rate of CD45is15.91%. However, in the control group, the stong positive expression rate of CD45is96%,and the weakly expression rate of CD45is4%. There are statistically differences between the two different groups, P<0.05.(4) There are no significant differences between the expression and positive rate of CD138,CD38,CD56,CD19,CD20,CD200and the groups which are divided by therapeutic efficacy of patients with MM, and P>0.05.The expression rate of CD86among remission group is substantially lower than that among the patients with newly diagnosed and unremission group, and P<0.05. There was no statistically differences between the expression rate of CD86in newly diagnosed group and unremission group, P>0.05.The expression rate of CD28has no significant differences among three groups, P>0.05.The positive rate of CD28in newly diagnosed group is apparently lower than remission group and the unremission group, P<0.05. The positive rate of CD28in three groups are as fellows:newly diagnosed group is16%(4/25), remission group is66.67%(6/9),and unremission group is70%(7/10) There are on differences between the positive rate of CD28in remission group and unremission group, P>0.05. The rates of expression in CD200, CD28, CD56, CD38, CD138and CD86have no statistically differences among the groups with IgA^IgG and light chain immunoglobulin, and P>0.05.(5) There are no statistically differences between the expression and positive rate of CD138,CD38,CD56, CD19,CD20,CD200in the three stages of ISS, and P>0.05. The expression rate of CD28in ISS stageⅡ is signally higher than the stage Ⅲ, P<0.05. The expression rate of CD28in ISS stage III is obviously higher than the early stage(stage Ⅰ and stage Ⅱ), and P<0.05The positive rate of CD28in ISS stage Ⅲ is obviously higher than the early stage(stage Ⅰ and stage Ⅱ), respectively were57.89%and24%, and P<0.05, and there are statistically differences between the two different groups.The expression rate of CD86in stage Ⅲ patients was higher than the early stage patients (including stage Ⅰ and stage Ⅱ), respectively are73.68%and40.00%, and P<0.05.Besides, the positive rate of CD86in stage III patients is evidently higher than the early stage(stage Ⅰ and stage Ⅱ) and stage Ⅱ patients, respectively are73.68%and36.84%, and P<0.05.There are no statistically differences between the expression and positive rate of CD138, CD38, CD56, CD19, CD20, CD200, CD28, CD86in three stages of Durie-Salmon Staging Standard, and P>0.05.(6) There are no statistically differences between the expression rate of CD56, CD20, CD86, CD19and the level of β2-microglobulin, albumin, hemoglobin,serum creatinine, and P>0.05.The level of β2-microglobulin in patients without expression of CD200is obviously higher than those with expression of CD200,and P<0.05. The level of β2-microglobulin in patients with expression of CD28is markedly higher than those without expression of CD28and P<0.05. The remission rate of positive expression of CD28is lower than negative expression of CD28in patients with MM, respectively are26.7%and37.5%. However, there are no statistically differences between the remission rate of CD28,and P>0.05. Statistically differences are not found between the expression rate of CD200,CD28among the lever of albumin, hemoglobin and serum creatinine,and P>0.05.Conclusions:(1) The expression frequency of plasma cell phenotype in patients with MM are as fellows:CD138+(97.72%) CD38+(100%) CD56+(63.64%) CD19-(84.09%) CD20+(11.63%) CD200+(77.27%) CD28+(38.64%) CD86+(54.55%).The expression frequency of normal plasma cell phenotype in the control group are as fellows:CD138+(100%) CD38+(100%) CD56-(100%) CD19+(96%) CD20-(100%) CD200-(100%) CD28-(100%) CD86-(100%)(2)Using the combinations of CD56, CD19, CD20, CD200, CD28, CD86,is conducive to identify the phenotype of malignant plasma cells of MM.(3). The fluorescence intensity of CD45in plasma cell of patients with MM can be negative, weakly positive or strong positive. However, fluorescence intensity of CD45in the control group can be eihter weakly positive or strong positive.(4) As the disease completely remitting, the expression rate of CD86will reduce.The positive rate of CD86in ISS stage Ⅲ patients is evidently higher than the early stage(stage Ⅰ and stage Ⅱ). The positive rate of CD28in newly diagnosed group is apparently lower than remission group and the unremission group. There are no statistically differences among the expression and positive rate of CD138, CD38, CD56, CD19, CD20, CD200, CD28, CD86three groups divided by the disease state, three groups with IgA^IgG and light chain immunoglobulin, and three stages of ISS or Durie-Salmon Staging Standard.(5) The patients with negative expression of CD200and the positive expression of CD28have a high level of serum β2-microglobulin.There are no statistically differences among the expression rate of CD56, CD20, CD86, CD19and the level of β2-microglobulin, albumin, hemoglobin,serum creatinine. |
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