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目的:研究多发性骨髓瘤(MM)3种常见IgH易位与骨髓瘤细胞形态学特征之间的相关性。方法:分析135例伴有t(4;14)、t(11;14)及t(14;16)的初诊MM患者骨髓涂片及外周血涂片中骨髓瘤细胞形态特征及比例。分别按照细胞成熟度及细胞大小的形态特征对浆细胞形态分类。按细胞成熟度分为成熟型(Ⅰ型)、幼稚型(Ⅱ型)、原始型(Ⅲ型)及中间型(Ⅳ型)浆细胞;按细胞大小分为大浆细胞和小浆细胞(又称为淋巴样浆细胞,LP-PC)。然后根据具有各种不同形态特征浆细胞所占比例,将骨髓瘤分为成熟型骨髓瘤(Ⅰ型骨髓瘤)、幼稚型骨髓瘤(Ⅱ型骨髓瘤)、浆母细胞型骨髓瘤(Ⅲ型骨髓瘤)、中间型骨髓瘤(Ⅳ型骨髓瘤),非成熟型骨髓瘤(Ⅱ型+Ⅲ型+Ⅳ型骨髓瘤)。分析3种IgH易位与不同细胞形态学分型及分类之间的关系。结果:t(11;14)患者中Ⅰ型骨髓瘤占53.45%(31/58),多于t(4;14)患者46.55%(27/58)(P<0.05),且t(11;14)中Ⅰ型浆细胞占总浆细胞比例为62.64%,高于t(4;14)患者50.14%(P<0.05)。t(11;14)患者中伴有LP-PC骨髓瘤占70.69%(41/58),显著多于t(4;14)患者6.85%(5/73)(P<0.05)。t(4;14)患者中非成熟型骨髓瘤占63.01%(46/73),显著多于t(11;14)患者46.55%(27/58)(P<0.05)。而t(14;16)患者例数较少(4/135),形态分类均为非成熟型骨髓瘤细胞且均未检出LP-PC。结论:不同的IgH易位与特定的骨髓瘤细胞形态学特征有关。
Objective: To study the correlation between the three common IgH translocations in multiple myeloma (MM) and the morphology of myeloma cells. Methods: The morphology and proportion of myeloma cells in bone marrow and peripheral blood smears of 135 newly diagnosed MM patients with t (4; 14), t (11; 14) and t (14; 16) were analyzed. Plasma cell morphology was classified according to the morphological characteristics of cell maturation and cell size respectively. According to cell maturity, the cells were divided into mature type (Ⅰ), immature (Ⅱ), primitive (Ⅲ) and intermediate (Ⅳ) plasma cells; Called lymphoid plasma cells, LP-PC). Myeloma is then divided into mature myeloma (type I myeloma), immature myeloma (type II myeloma), plasmablastic myeloma (type III Myeloma), intermediate myeloma (type IV myeloma), and non-myeloma (type II + type III + type IV myeloma). The relationship between the three IgH translocations and the morphological classification and classification of different cells was analyzed. Results: Type Ⅰ myeloma accounted for 53.45% (31/58) in t (11; 14) patients, which was significantly higher than that in t (4; 14) patients (46.55%, 27/58) 14), the percentage of type I plasma cells in total plasma cells was 62.64%, higher than that in t (4; 14) patients (50.14%, P <0.05). There were 70.69% (41/58) patients with LP-PC myeloma in t (11; 14) patients, which was significantly more than that in t (4; 14) patients (6.85%, 5/73) The prevalence of immature myeloma in t (4; 14) patients was 63.01% (46/73), significantly higher than that in t (11; 14) patients (46.55%, 27/58) (P <0.05). The number of patients with t (14; 16) was lower (4/135). The morphological classification was all immature myeloma cells and no LP-PC was detected. CONCLUSIONS: Different IgH translocations are associated with specific myeloma cell morphological characteristics.