目的:探讨脊柱浆细胞骨髓瘤（plasma cell myeloma，PCM）中骨桥蛋白(osteopontin，OPN)的表达及其与临床病理特征和预后的相关性。方法：选取第二军医大学长征医院19982006年间41例脊柱PCM及14例脊柱良性单纯性骨囊肿手术切除标本；应用免疫组织化学链霉菌抗生物素蛋白过氧化物酶连结（SP）法检测OPN的表达。结果：（1）OPN在脊柱PCM中的阳性表达率为82.93%(34/41) ，而良性骨囊肿中OPN表达均呈阴性 (P<0.01)；（2）脊柱PCM中OPN蛋白的表达程度在M蛋白分型和临床分型各组之间差异均有统计学意义（P<0.05），而与患者轻链分型、病理形态学分级、年龄和性别无显著关联（P>0.05）；（3）OPN表达阳性患者整体生存率明显高于阴性组(P<0.01)。结论：OPN表达阴性脊柱PCM患者的预后可能较差。联合检测OPN和M蛋白分型以及临床分型对脊柱PCM预后判断可能有一定的临床意义。

Objective: To investigate the expression of osteopontin (OPN) in spinal plasma cell myeloma (PCM) and its relationship with the clinicopathological characteristics and prognoses of PCM patients. Methods: Fortyone PCM and 14 spinal simple bone cysts samples were obtained from Affiliated Changzheng Hospital of Second Military University (19982006) after surgery. The expression of OPN was determined by streptavidinperosidase (SP) immunohistochemical staining. Results: (1) The positive expression rate of OPN in spinal PCM tissues was 82.93% (34/41), and it was absent in spinal simple bone cyst tissues(P<0.01). (2) The expression of OPN in spinal PCM tissues was correlated with clinical and Mcomponent classifications of PCM (P<0.05)，but was not correlated with the type of light chain, pathological stage, age or gender of patients (P>0.05). (3) The overall survival rate of OPN positive PCM patients was higher than that of OPN negative patients (P<0.01). Conclusion: OPN negative PCM patients are liable to have a poor prognosis. The clinical and Mcomponent classifications combined with detection of OPN expression in PCM patients maybe used for predication of prognoses of PCM patients.

第二军医大学长征医院青年科研启动基金(No.200915)