Clin Lab. 2024 Oct 1;70(10). doi: 10.7754/Clin.Lab.2024.240148.
This study aimed to investigate the value of the peripheral blood neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) in the prognosis of patients with multiple myeloma (MM).
Before treatment, the NLR and LMR and all clinical indicators of 168 patients, diagnosed with MM at the Affiliated Hospital of Southwest Medical University from April 2013 to April 2022, were retrospectively analyzed, and the patients were grouped according to their median NLR counts and median LMR counts. Differences between the groups were compared by using the chi-squared (χ²) test, the Kaplan-Meier survival curve and Log-rank test were used for survival analysis and difference comparison, and the COX proportional risk model was constructed to analyze the factors affecting the prognosis of the MM patients. The test level was α = 0.05.
The groups were divided into high NLR group (> 2.19) and low NLR group (≤ 2.19) and high LMR group (> 3.45) and low LMR group (≤ 3.45), according to the median NLR and LMR values. The clinical stage, blood β2 microglobulin, and serum creatinine levels in the high NLR group were higher than in the low NLR group, and the differences between the groups were statistically significant (p < 0.05). The clinical stage and blood β2 microglobulin in the low LMR group were higher than in the high LMR group, and the differences between the groups were statistically significant (p < 0.05). The Cox univariate and multivariate analyses showed that peripheral blood NLR < 2.19 and LMR ≤ 3.45 were independent risk factors for the prognosis in patients with MM (p < 0.05).
High NLR and low LMR counts of peripheral blood suggest a poor prognosis; NLR and LMR may be prognostic indicators in MM patients.
本研究旨在探讨外周血中性粒细胞与淋巴细胞比值（NLR）和淋巴细胞与单核细胞比值（LMR）在多发性骨髓瘤（MM）患者预后评估中的价值。
回顾性分析 2013 年 4 月至 2022 年 4 月西南医科大学附属医院收治的 168 例 MM 患者的外周血 NLR 和 LMR 及所有临床指标，根据 NLR 中位数和 LMR 中位数将患者进行分组。采用卡方（χ²）检验比较组间差异，Kaplan-Meier 生存曲线和 Log-rank 检验进行生存分析和差异比较，采用 COX 比例风险模型分析影响 MM 患者预后的因素。检验水准α=0.05。
根据 NLR 和 LMR 的中位数将患者分为高 NLR 组（>2.19）和低 NLR 组（≤2.19）以及高 LMR 组（>3.45）和低 LMR 组（≤3.45）。高 NLR 组的临床分期、血β2 微球蛋白、血清肌酐水平高于低 NLR 组，差异有统计学意义（p<0.05）。低 LMR 组的临床分期和血β2 微球蛋白水平高于高 LMR 组，差异有统计学意义（p<0.05）。Cox 单因素和多因素分析显示，外周血 NLR<2.19 和 LMR≤3.45 是 MM 患者预后的独立危险因素（p<0.05）。
外周血 NLR 升高和 LMR 降低提示预后不良；NLR 和 LMR 可能是 MM 患者的预后指标。
