Yang Wen-Hui, Sun Yan-Qing, Zhang Qi-Ke, Wei Xiao-Fang, Li Gao
Gansu Provincial Hospital of TCM, Lanzhou 730000, Gansu Province, China,Ningxia Medical University, Yinchuan 750000, Ningxia Province, China.
Department of Hematology, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu Province, China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Feb;29(1):122-130. doi: 10.19746/j.cnki.issn.1009-2137.2021.01.020.
To investigate the effect of neutrophil/lymphocyte ratio (NLR) and monocyte/lymphocyte ratio (MLR) in the valuation prognosis of patients with multiple myeloma (MM).
The clinical data of 82 patients with initially diagnosed MM admitted to Gansu Provincial People's Hospital was analyzed retrospectively. NLR and MLR were calculated based on blood routine results respectively. The optimal cut-off point of NLR and MLR was determined according to the ROC curve, and the patients were divided into the high NLR/MLR group and the low NLR/MLR group. The general data, biochemical indicators and prognosis of the patients in each groups were compared respectively. The prognostic significance of the high NLR/MLR group and the low NLR/MLR group in patients between different treatment regimens and different clinical characteristics were analyzed. Risk stratification was designed based on NLR and high MLR as two risk factors, and the effect of risk factors, on the prognosis of MM patients were compared.
ROC curve analysis determined that the optimal cut-off point of NLR was 3.1 (sensitivity 75%, specificity 70.7%) and the optimal cut-off point of MLR was 0.34 (sensitivity 83.3%, specificity 53.4%). The lactate dehydrogenase (LDH) and mean platelet volume (MPV) were correlated to NLR and MLR (P<0.05). There were no significant difference in age, sex, serum calcium (Ca), β -microglobulin (β -MG), albumin (Alb), hemoglobin (Hb), platelet (PLT), serum creatinine (Cr), bone marrow plasma cell ratio and ISS stage between the two groups (P>0.05). The OS rate of patients with higher NLR and MLR was lower than those with low NLR and MLR and showed poor prognosis; Further analysis showed that there were statistically significant differences in OS time among patients with different MLR and NLR in the new drug treatment group and the traditional chemotherapy group, as well as patients in different age stratification groups, different β -MG stratification groups and different serum creatinine stratification groups. Patients with 2 risk factors showed a poorer prognosis than those with 0-1 risk factor.
Elevated NLR and MLR are associated with poor prognosis in MM patients and may serve as the cost-effective and readily available prognostic biomarkers.
探讨中性粒细胞/淋巴细胞比值（NLR）和单核细胞/淋巴细胞比值（MLR）在多发性骨髓瘤（MM）患者预后评估中的作用。
回顾性分析甘肃省人民医院收治的82例初诊MM患者的临床资料。分别根据血常规结果计算NLR和MLR。根据ROC曲线确定NLR和MLR的最佳截断点，并将患者分为高NLR/MLR组和低NLR/MLR组。分别比较两组患者的一般资料、生化指标及预后情况。分析高NLR/MLR组和低NLR/MLR组在不同治疗方案及不同临床特征患者中的预后意义。以NLR和高MLR作为两个危险因素进行风险分层，比较危险因素对MM患者预后的影响。
ROC曲线分析确定NLR的最佳截断点为3.1（灵敏度75%，特异度70.7%），MLR的最佳截断点为0.34（灵敏度83.3%，特异度53.4%）。乳酸脱氢酶（LDH）和平均血小板体积（MPV）与NLR和MLR相关（P<0.05）。两组患者在年龄、性别、血清钙（Ca）、β2微球蛋白（β2-MG）、白蛋白（Alb）、血红蛋白（Hb）、血小板（PLT）、血清肌酐（Cr）、骨髓浆细胞比例及国际分期系统（ISS）分期方面差异均无统计学意义（P>0.05）。NLR和MLR较高患者的总生存（OS）率低于NLR和MLR较低患者，预后较差；进一步分析显示，新药治疗组和传统化疗组中不同MLR和NLR的患者，以及不同年龄分层组、不同β2-MG分层组和不同血清肌酐分层组患者的OS时间差异均有统计学意义。有2个危险因素的患者预后较有0-1个危险因素的患者差。
NLR和MLR升高与MM患者预后不良相关，可作为经济有效且易于获得的预后生物标志物。
