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目的:探讨不同培养方法对多发性骨髓瘤(multiple myeloma,MM)患者异常核型检出率的影响。方法:以25例随访诊治的MM患者为研究对象,抽取并分离单个核细胞,分别经直接法、24h短期培养法及添加白细胞介素6(IL-6)10ng/ml的72h培养法后再进行R显带分析。以10例明确诊断的巨幼细胞性贫血患者为对照组。结果:2例标本3组培养法中常规核型分析均未见分裂相或分裂相少且质量较差;其余23例标本均在各组见可分析分裂相。可分析的23例患者中直接法组均未检出异常核型;24h短期培养法组检出异常核型2例;添加细胞因子的72h培养法组检出异常核型5例。经确切概率法检验,添加细胞因子组的异常核型检出率明显高于直接法组(P=0.048);而与24h短期培养法组则无显著性差异(P=0.079)。统计学分析证实异常核型的检出与患者骨髓浆细胞水平及血清β2-微球蛋白(β2-MG)显著相关。对照组均未检出异常核型。结论:延长培养时间并添加细胞因子可以提高MM患者异常核型的检出率。
Objective: To investigate the effect of different culture methods on the detection rate of abnormal karyotype in multiple myeloma (MM). Methods: Mononuclear cells (MMs) were collected from 25 patients with MM who were followed up. The cells were cultured for 72 h with direct method, 24h short-term culture and IL-6 supplemented with 10 ng / ml R banding analysis. 10 cases of diagnosed patients with megaloblastic anemia as a control group. Results: There was no schizonts or schizophrenia with poor quality in routine karyotype analysis in the three groups of two specimens. The other 23 specimens were analyzed in all groups. No abnormal karyotypes were detected in the direct method group of 23 patients; 2 cases of abnormal karyotype detected in 24h short-term culture group; 5 cases of abnormal karyotype detected by 72 h cytokine-supplemented group. The exact karyotype test showed that the detection rate of abnormal karyotype was significantly higher in the cytokines group than in the direct method group (P = 0.048), but not significantly different from that in the 24h short-term culture group (P = 0.079). Statistical analysis confirmed abnormal karyotype detected in patients with bone marrow plasma cells and serum β2-microglobulin (β2-MG) was significantly correlated. No abnormal karyotype was detected in the control group. Conclusion: Prolonging the culture time and adding cytokines can improve the detection rate of abnormal karyotypes in MM patients.