Department of Hematology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.
Department of Hematology, Ji'an Hospital of Shanghai East Hospital, Ji'an, 343000 Jiangxi, China.
Dis Markers. 2022 Oct 12;2022:2095696. doi: 10.1155/2022/2095696. eCollection 2022.
The study is aimed at analyzing the predictive value of serum Ig A, Ig G, and TNF- in the recurrence of multiple myeloma (MM).
136 patients with MM treated in our hospital from January 2010 to January 2017 were followed up for 5 years. Finally, 100 patients who met the inclusion and exclusion criteria and had the complete follow-up visit were selected as the study subjects, with the recurrence of MM as endpoint event, and the observation was taken until the occurrence of endpoint event in patients or the termination of this study. They were divided into the recurrence group (RG) and the nonrecurrence group (NRG) according to whether the endpoint event occurred. The venous blood of patients was collected at the first diagnosis and subsequent visit (at the time of recurrence or termination of the study) to measure the Ig A and Ig G using a full automatic special protein analyzer and the TNF- level by enzyme-linked immunosorbent assay. The data obtained in this study were analyzed by univariate analysis to choose the factors with difference in statistical significance to draw the ROC curve, and the areas under the curve (AUC) were recorded to analyze the potential mechanism of Ig A, Ig G, and TNF- in predicting the recurrence of MM.
After follow-up visit, there were 62 patients with recurrence (62.0%) and 38 patients without recurrence (38.0%), with no obvious difference in gender, age, body weight, and immune classification between the two groups ( > 0.05). Compared with the NRG, the levels of soluble interleukin-2 receptor (sIL-2R) and -microglobulin ( -MG) in the RG at the first diagnosis were distinctly higher ( < 0.001); the levels of Ig A, Ig G, and TNF- in the RG at the first diagnosis were visibly higher ( < 0.05); and the levels of Ig A, Ig G, and TNF- in the RG at the subsequent visit were clearly higher ( < 0.05). There was a correlation between Ig G, Ig A, and TNF- and -MG at the first diagnosis and the subsequent visit ( < 0.05); there was a correlation between Ig G and TNF-, and sIL-2R at the first diagnosis and the subsequent visit ( < 0.05); and there was a correlation between Ig A and sIL-2R at the subsequent visit ( < 0.05). The AUC of Ig G, Ig A, and TNF- in predicting the MM at the first diagnosis were 0.772, 0.776, and 0.778, respectively.
The serum Ig A, Ig G, and TNF- had a predictive value in the recurrence of MM, and TNF- was correlated with sIL-2R and -MG, with the highest AUC and the best predictive value.
本研究旨在分析血清 IgA、IgG 和 TNF-对多发性骨髓瘤（MM）复发的预测价值。
对 2010 年 1 月至 2017 年 1 月在我院治疗的 136 例 MM 患者进行随访 5 年，最终选取符合纳入和排除标准且随访完整的 100 例患者为研究对象，以 MM 复发为终点事件，观察至患者出现终点事件或本研究终止。根据终点事件是否发生，将患者分为复发组（RG）和未复发组（NRG）。患者首次诊断及后续就诊时（复发或研究终止时）采集静脉血，采用全自动特种蛋白分析仪检测 IgA 和 IgG，酶联免疫吸附法检测 TNF-水平。对本研究获得的数据进行单因素分析，选择有统计学意义差异的因素绘制 ROC 曲线，记录曲线下面积（AUC），分析 IgA、IgG 和 TNF-预测 MM 复发的潜在机制。
随访后，有 62 例患者（62.0%）复发，38 例患者（38.0%）未复发，两组患者的性别、年龄、体重、免疫分型比较，差异均无统计学意义（>0.05）。与 NRG 相比，RG 患者首次诊断时可溶性白细胞介素-2 受体（sIL-2R）和 -微球蛋白（-MG）水平明显升高（<0.001）；首次诊断时 RG 患者的 IgA、IgG 和 TNF-水平明显升高（<0.05）；随后就诊时 RG 患者的 IgA、IgG 和 TNF-水平明显升高（<0.05）。首次诊断和随后就诊时，IgG、IgA 和 TNF-与 -MG 之间存在相关性（<0.05）；首次诊断和随后就诊时，IgG 与 TNF-和 sIL-2R 之间存在相关性（<0.05）；随后就诊时，IgA 与 sIL-2R 之间存在相关性（<0.05）。首次诊断时，IgG、IgA 和 TNF-预测 MM 的 AUC 分别为 0.772、0.776 和 0.778。
血清 IgA、IgG 和 TNF-对 MM 复发有预测价值，其中 TNF-与 sIL-2R 和 -MG 相关，AUC 最高，预测价值最好。
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