多发性骨髓瘤患者的肿瘤负荷：β₂-微球蛋白水平与低剂量全身 CT 比较。

Tumor load in patients with multiple myeloma: β₂-microglobulin levels versus low-dose whole-body CT.

机构信息

Department of Radiology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.

Department of Medical Imaging, Mater Dei Hospital, Valletta, Malta.

出版信息

Eur J Haematol. 2020 May;104(5):383-389. doi: 10.1111/ejh.13356. Epub 2020 Mar 9.

DOI:10.1111/ejh.13356

PMID:31762076

Abstract

OBJECTIVE

Beta-2-microglobulin is a serum marker of tumor burden in multiple myeloma (MM). Our aim was to correlate serum β₂-microglobulin levels in patients with MM to tumor burden determined by low-dose whole-body CT (LDWBCT).

MATERIALS AND METHODS

A total of 52 patients with newly diagnosed, untreated MM who underwent LDWBCT were included. LDWBCT scans were assessed by two musculoskeletal radiologists in consensus for focal lesions. The Durie and Salmon PLUS staging system was used for staging patients in stages I-III. β₂-microglobulin was also subdivided into stages I-III on the basis of the multiple myeloma International Staging System (ISS).

RESULTS

Using the Durie and Salmon PLUS staging system criteria for image evaluation, we were able to identify stage I MM in 17 patients, stage II MM in nine patients, and stage III MM in 26 patients. Eight of nine patients with stage II MM and 16 of 26 patients with stage III MM had normal β₂-microglobulin levels. Thus, 24 of 35 patients (68.6%) had 5 or more focal lesions and false-negative β₂-microglobulin levels.

CONCLUSION

Serum β₂-microglobulin levels alone may not indicate the full extent of tumor burden in a significant subset of myeloma patients.

摘要

目的

β2-微球蛋白是多发性骨髓瘤（MM）肿瘤负担的血清标志物。我们的目的是将 MM 患者的血清β2-微球蛋白水平与通过低剂量全身 CT（LDWBCT）确定的肿瘤负担相关联。

材料和方法

共纳入 52 例新诊断、未经治疗的 MM 患者，这些患者均接受了 LDWBCT。两名肌肉骨骼放射科医生对 LDWBCT 扫描进行了评估，以达成共识，对病灶进行评估。Durie 和 Salmon PLUS 分期系统用于分期 I-III 期患者。β2-微球蛋白也根据多发性骨髓瘤国际分期系统（ISS）分为 I-III 期。

结果

使用 Durie 和 Salmon PLUS 分期系统的图像评估标准，我们能够识别 17 例 I 期 MM、9 例 II 期 MM 和 26 例 III 期 MM。9 例 II 期 MM 中有 8 例和 26 例 III 期 MM 中有 16 例患者的β2-微球蛋白水平正常。因此，35 例患者中有 24 例（68.6%）有 5 个或更多病灶，且β2-微球蛋白水平呈假阴性。