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以克隆性免疫球蛋白重链（ＩｇＨ）基因重排为骨髓瘤细胞基因标志，应用半巢式ＰＣＲ基因扩增技术检测多发性骨髓瘤（ＭＭ）患者外周血肿瘤相关Ｂ细胞。结果２６例ＭＭ中１７例阳性，其中临床１期均阴性（０／６），Ⅱ期６例（６／８），Ⅲ期１１例（１１／１２），Ⅱ、Ⅲ期阳性率明显高于Ⅰ期（Ｐ＜０．０１）。９例部分缓解患者均阴性（０／９），１０例难治性ＭＭ均阳性（１０／１０），两者相差非常显著（Ｐ＜０．０１）。１７例患者骨髓与外周血克隆性ＩｇＨ基因重排完全相同。提示ＭＭ外周血肿瘤相关Ｂ细胞阳性率与临床分期和化疗疗效相关，对于探讨骨髓瘤细胞克隆起源，判断病情及化疗疗效均有重要价值。
The clonal immunoglobulin heavy chain (IgH) gene rearrangements were used as genetic markers of myeloma cells. Semi-nested PCR amplification was used to detect peripheral blood tumor-associated B cells in patients with multiple myeloma (MM). Results Of the 26 MM patients, 17 were positive, of which 1 was negative (0/6), 6 (6/8) in stage Ⅱ and 11 (11/12) in stage Ⅲ, and the positive rates in stage Ⅱ and stage Ⅲ were significantly higher than those in stage Ⅱ Stage I (P <0.01). All 9 patients with partial remission were negative (0/9), and 10 patients with refractory MM were all positive (10/10). The difference between the two groups was significant (P <0.01). 17 cases of bone marrow and peripheral blood clonal IgH gene rearrangement exactly the same. It is suggested that the positive rate of B cells in peripheral blood of MM patients is correlated with the clinical stage and the curative effect of chemotherapy. It is of great value to explore the origin of the myeloma cell clones, to judge the condition and the curative effect of chemotherapy.