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多发性骨髓瘤临床分期系统的预后分析与评估——附206例报告

[Prognostic analysis and assessment on the clinical staging systems of multiple myeloma--a report of 206 cases].

作者信息

Tao Zhong-Fei, Fu Wei-Jun, Chen Yu-Bao, Yuan Zhen-Gang, Wang Dong-Xing, Hou Jian

机构信息

Department of Hematology, Changzheng Hospital, The Second Military Medical University, Shanghai 200003, P. R. China.

出版信息

Ai Zheng. 2006 Apr;25(4):461-4.

Abstract

BACKGROUND & OBJECTIVE: Multiple myeloma (MM) is a heterogeneous disease of plasma cell tumor with poor prognosis. This study was to explore the prognostic factors of MM in China, and find the most suitable clinical staging systems.

METHODS

Univariate and multivariate analyses were carried out on 18 clinical and laboratory indexes from 206 MM patients. These MM patients were classified according to 4 staging systems to compare their survival status.

RESULTS

Of the 206 patients, 138 were men and 68 were women, with median age of 59 years (ranged 27-90 years) and median survival time of 33 months. The 2-and 5-year survival rates were 64.7% and 33.7%. Univariate analysis identified 10 prognostic factors: age, the amount of bone marrow plasma cells, hemoglobin, platelet count, adjusted serum calcium, albumin, creatinine, beta2 microglobulin, C-reactive protein, and skeletal disease stage. Multivariate analysis showed that C-reactive protein, beta2 microglobulin, albumin, age were independent prognostic factors. Significant differences of survival period existed among the 3 groups classified according to Durie Salmon staging system and Bataille staging system as well as between group I and group II of International staging system. However, no significant difference was found among the 3 groups classified according to British Medical Research Council staging system and between group II and group III of International staging system.

CONCLUSIONS

High level of C-reactive protein, high level of beta2 microglobulin, low level of albumin and old age are correlated to poor prognosis. Durie Salmon staging system and Bataille staging system are suitable for Chinese MM patients.

摘要

背景与目的

多发性骨髓瘤(MM)是一种异质性浆细胞瘤疾病,预后较差。本研究旨在探讨中国MM的预后因素,并找出最合适的临床分期系统。

方法

对206例MM患者的18项临床和实验室指标进行单因素和多因素分析。这些MM患者根据4种分期系统进行分类,以比较其生存状况。

结果

206例患者中,男性138例,女性68例,中位年龄59岁(27 - 90岁),中位生存时间33个月。2年和5年生存率分别为64.7%和33.7%。单因素分析确定了10个预后因素:年龄、骨髓浆细胞数量、血红蛋白、血小板计数、校正血清钙、白蛋白、肌酐、β2微球蛋白、C反应蛋白和骨骼疾病分期。多因素分析显示,C反应蛋白、β2微球蛋白、白蛋白、年龄是独立的预后因素。根据Durie Salmon分期系统和Bataille分期系统分类的3组之间以及国际分期系统的I组和II组之间生存期存在显著差异。然而,根据英国医学研究委员会分期系统分类的3组之间以及国际分期系统的II组和III组之间未发现显著差异。

结论

C反应蛋白水平高、β2微球蛋白水平高、白蛋白水平低和年龄大与预后不良相关。Durie Salmon分期系统和Bataille分期系统适用于中国MM患者。

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