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Objective : This study was purposed to investigate the immunophenotype and molecular genetics characteristics in multiple myeloma (MM), clear characteristic immunophenotype of malignant plasma cell and stability, investigate the inner relationship between different antigen expression patterns and molecular genetics,provide basis for the multiple myeloma ’s Diagnosis, evaluation, prognosis, Minimal residual disease and monoclonal treatment .Methods: Detect the expression levels of various immune markers of 32 cases of MM patients and 10 cases Iron deficiency anemia patients by flow cytometry (FCM) ; analysis tumor cell surface abnormal antigen expression patterns and antigen expression of stability ; analyze the difference between the expression of CD56、CD19、CD117、CD28,、CD20、CD27 and the clinical stage, disease stage, type of immunoglobulin ,find out their correlations with clinical indicator; Detecting 13q deletion and IGH rearrangement of 19 cases of bone marrow cells in MM patients by interphase fluorescence in situ hybridization (I-FISH) ,investigate the inner relationship between antigen expression patterns and molecular genetics abnormalities.Results: (1)Compared with control, myeloma cells do not express CD19 (96.88%), overexpression of CD56 (93.75%), part expression of CD117 (40.63%), CD28 (43.75%), CD20 (18.75%), CD27 (43.75%), and partial immunophenotype has changes after monoclonal antibody therapy (41.67%).(2)The expression of CD117 in MM has statistically significant differences between stagingⅠperiod and stagingⅡ、Ⅲp eriod of DS stage (F = 6.626, P = 0.004)and the expression of three group decreased step by step. The others antigen expression in clinical stage, disease stage, immunoglobulin type were no statistically significant differences models.(3) The percentage of malignant plasma cells by flow cytometry and morphological tumor cells load obvious positive correlation (γ= 0.697, P <0.001), and significantly higher in aggressive stage than in stable stage(P <0.001).(4) Compared with normal controls, 13q14.3 deletion accounted for 31.58% ,RB1 loss accounted for 21.05% in MM patients ,and 42.10% of the patients with 13q14 deletion (including the deletion of 13q14.3 and RB1). 57.89% of the patients present IGH translocation, more in CD117– group (P = 0.024), and with the clinical index unrelated.Conclusion: The immune markers expression patterns of myeloma tumor cell detected by flow cytometry provide basis for the diagnosis, evaluation, prognosis, minimal residual disease and monoclonal treatment. The heterogeneity and instability of antigen expression in tumor cells requires increase the antigen detection range in detecting minimal residual disease by flow cytometry and treating by monoclonal antibody. On the other hand, the potential correlation between molecular genetic abnormalities and expression patterns of specific antigens need further research.
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