Li Manning, Wu Han, Shou Chunyi, Peng Ye, Song Xiaolu, Ying Wang, Chen Yirui, Tong Xiangmin
Graduate School of Clinical Medicine, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121001, Liaoning, China.
Cancer Center, Department of Hematology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, People's Republic of China.
Discov Oncol. 2024 Sep 27;15(1):477. doi: 10.1007/s12672-024-01254-z.
This study aims to identify clinical laboratory parameters for the diagnosis of newly diagnosed multiple myeloma (NDMM), establish optimal cutoffs for early screening, and develop a diagnostic model for precise diagnosis.
The study conducted a retrospective analysis of 279 NDMM patients and 553 healthy subjects at Zhejiang Province People's Hospital between January 2008 and June 2023. Multifactor LR was employed to explore clinical laboratory indicators with diagnostic value for NDMM, determine optimal cutoff values and contract a diagnostic model. The diagnostic efficacy and clinical utility were evaluated using receiver operating characteristic curves (ROC), sensitivity, specificity, and other indicators.
Multifactor analysis revealed that hemoglobin (Hb), albumin (Alb), and platelet distribution width (PDW) were significant diagnostic factors for NDMM. Optimal cutoff values for Hb, Alb, and PDW in MM diagnosis were determined, and the results showed a significant increase in the probability of NDMM diagnosis when Alb was below 39.3 g/L, Hb was below 11.6 g/dL, and PDW was below 14.1 fL. The diagnostic model constructed from the development cohort demonstrated a high area under the ROC curve of 0.960 (95% CI 0.942-0.978) and exhibited good sensitivity (0.860), specificity (0.957). The area under the curve (AUC) value of the diagnostic model in the external validation cohort was 0.979, confirming its good diagnostic efficacy and generalization.
The optimal cutoff values for Hb, Alb, and PDW and the diagnostic model designed in the study provided good accuracy and sensitivity for the initial screening and diagnosis of NDMM.
本研究旨在确定新诊断多发性骨髓瘤（NDMM）的临床实验室参数，建立早期筛查的最佳临界值，并开发精确诊断的诊断模型。
本研究对2008年1月至2023年6月期间浙江省人民医院的279例NDMM患者和553例健康受试者进行了回顾性分析。采用多因素逻辑回归（LR）探索对NDMM具有诊断价值的临床实验室指标，确定最佳临界值并构建诊断模型。使用受试者工作特征曲线（ROC）、敏感性、特异性等指标评估诊断效能和临床实用性。
多因素分析显示，血红蛋白（Hb）、白蛋白（Alb）和血小板分布宽度（PDW）是NDMM的重要诊断因素。确定了MM诊断中Hb、Alb和PDW的最佳临界值，结果显示，当Alb低于39.3 g/L、Hb低于11.6 g/dL且PDW低于14.1 fL时，NDMM诊断概率显著增加。从开发队列构建的诊断模型在ROC曲线下面积较高，为0.960（95%CI 0.942-0.978），敏感性良好（0.860），特异性良好（0.957）。外部验证队列中诊断模型的曲线下面积（AUC）值为0.979，证实了其良好的诊断效能和泛化能力。
本研究设计的Hb、Alb和PDW最佳临界值及诊断模型为NDMM的初步筛查和诊断提供了良好的准确性和敏感性。
