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基于非遗传预测因子的多发性骨髓瘤综合分析和预后模型的建立。

Comprehensive analysis and establishment of a prognostic model based on non-genetic predictors in multiple myeloma.

机构信息

The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.

Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.

出版信息

Cancer Biomark. 2023;38(1):49-59. doi: 10.3233/CBM-220451.

DOI:10.3233/CBM-220451
PMID:37522196
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10578287/
Abstract

BACKGROUND

Multiple myeloma (MM) is a systemic hematological malignancy usually incurable. The value of some important prognostic factors may gradually decrease.

OBJECTIVE

We aimed to explore the non-genetic indexes, prognostic models, and significance of clinical staging systems of MM.

METHODS

A retrospective analysis was conducted on clinical data from 110 patients with MM who first visit the First Affiliated Hospital of Guangzhou Medical University between September 2005 to December 2018.

RESULTS

Bone marrow plasma cell percentage (BMPC%), cystatin C (CysC), and β2 microglobulin (β2-MG) were positively correlated with Durie-Salmon (D-S) and international staging system (ISS) stages, while red blood cell count (RBC) and hemoglobin volume (HGB) were negatively correlated (P< 0.05). Univariate analysis showed that ISS stage, treatment protocol, immunofixation electrophoresis (IFE), ratio of red cell distribution width to platelet count (RPR), monocyte count (MONO), lactate dehydrogenase, and immunoglobulin G were significantly associated with the three-year overall survival (OS). IFE, treatment protocol, and β2-MG significantly affected progression-free survival (P< 0.05). Multivariate analysis showed that the treatment protocol, ISS stage, RPR, MONO, and IFE were independent prognostic factors for three-year OS (P< 0.05).

CONCLUSIONS

BMPC%, CysC, and β2-MG were positively correlated with both clinical staging systems and RBC and HGB were negatively correlated. RPR and MONO affect MM prognosis and the established prognostic model can guide patient prognosis.

摘要

背景

多发性骨髓瘤（MM）是一种无法治愈的全身性血液系统恶性肿瘤。一些重要预后因素的价值可能逐渐降低。

目的

探讨 MM 的非遗传指标、预后模型和临床分期系统的意义。

方法

对 2005 年 9 月至 2018 年 12 月首次就诊于广州医科大学第一附属医院的 110 例 MM 患者的临床资料进行回顾性分析。

结果

骨髓浆细胞百分比（BMPC%）、半胱氨酸蛋白酶抑制剂 C（CysC）和β2 微球蛋白（β2-MG）与 Durie-Salmon（D-S）和国际分期系统（ISS）分期呈正相关，而红细胞计数（RBC）和血红蛋白体积（HGB）与 ISS 分期呈负相关（P<0.05）。单因素分析显示，ISS 分期、治疗方案、免疫固定电泳（IFE）、红细胞分布宽度与血小板计数比值（RPR）、单核细胞计数（MONO）、乳酸脱氢酶和 IgG 与 3 年总生存（OS）显著相关。IFE、治疗方案和β2-MG 显著影响无进展生存（P<0.05）。多因素分析显示，治疗方案、ISS 分期、RPR、MONO 和 IFE 是 3 年 OS 的独立预后因素（P<0.05）。

结论

BMPC%、CysC 和β2-MG 与临床分期系统呈正相关，RBC 和 HGB 呈负相关。RPR 和 MONO 影响 MM 预后，建立的预后模型可指导患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03ab/10578287/f56e06789866/cbm-38-cbm220451-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03ab/10578287/d9c52f4c0811/cbm-38-cbm220451-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03ab/10578287/d9bef137f16c/cbm-38-cbm220451-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03ab/10578287/f56e06789866/cbm-38-cbm220451-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03ab/10578287/d9c52f4c0811/cbm-38-cbm220451-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03ab/10578287/d9bef137f16c/cbm-38-cbm220451-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03ab/10578287/f56e06789866/cbm-38-cbm220451-g003.jpg

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