Yun Jae-Pil, Suh Cheolwon, Lee Eunkyoung, Chang Jai Won, Yang Won Seok, Park Jung Sik, Park Su-Kil
Department of Internal Medicine, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
J Korean Med Sci. 2006 Aug;21(4):639-44. doi: 10.3346/jkms.2006.21.4.639.
A new staging system for multiple myeloma (MM) has utilized serum concentrations of beta2-microglobulin (Sbeta2M) and albumin as important prognostic factors for survival. Since Sbeta2M is an indicator of glomerular filtration rate, we compared the prognostic values of Sbeta2M and 24-hr urinary creatinine clearance (Ccr) in patients with MM. We retrospectively reviewed the records of 170 MM patients from January 1996 to November 2003 whose 24-hr urinary Ccr was available at the time of diagnosis. We found that pretreatment Sbeta2M was inversely related to Ccr (Spearman's correlation coefficient=-0.787). In univariate analysis, the hazard ratio (HR) of death was 1.043 (p<0.001) for Sbeta2M and 0.985 (p<0.001) for Ccr. Multivariate analysis showed that Sbeta2M (HR 1.030, p=0.010) and Ccr (HR 0.993, p=0.059) were significant prognostic factors in patients' survival. In conclusion, 24-hr urinary Ccr may be utilized for staging of patients with MM.
一种新的多发性骨髓瘤（MM）分期系统将血清β2-微球蛋白（Sβ2M）浓度和白蛋白作为生存的重要预后因素。由于Sβ2M是肾小球滤过率的一个指标，我们比较了MM患者中Sβ2M和24小时尿肌酐清除率（Ccr）的预后价值。我们回顾性分析了1996年1月至2003年11月期间170例MM患者的记录，这些患者在诊断时可获得24小时尿Ccr数据。我们发现治疗前Sβ2M与Ccr呈负相关（Spearman相关系数=-0.787）。单因素分析显示，Sβ2M的死亡风险比（HR）为1.043（p<0.001），Ccr为0.985（p<0.001）。多因素分析表明，Sβ2M（HR 1.030，p=0.010）和Ccr（HR 0.993，p=0.059）是患者生存的重要预后因素。总之，24小时尿Ccr可用于MM患者的分期。
