Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt.
Internal Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Expert Rev Hematol. 2024 Nov;17(11):841-853. doi: 10.1080/17474086.2024.2417085. Epub 2024 Oct 17.
Multiple myeloma (MM) is a malignant incurable disease characterized by monoclonal plasma cell increase associated with renal impairment. Evaluation of neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), hemoglobin/red cell distribution width (HB/RDW), interleukin-20 (IL-20), and vascular endothelial growth factor-A (VEGFA) in patients with MM (with or without renal impairment) as prognostic and severity indicators.
A cross-sectional study was conducted on sixty MM patients with renal impairment, sixty MM patients without renal impairment, and sixty subjects (control group). Complete blood count, IL-20 immunoassay, and gene expression of IL-20, and VEGFA were evaluated.
Higher levels of NLR, MLR, and IL-20, and moreover lower levels of PLR, HB/RDW, as well as upregulation of IL-20, and VEGFA gene expression were detected in MM patients, especially those with renal impairment. Receiver operating characteristic curves analysis of NLR, MLR, PLR, and IL-20 showed high sensitivity and specificity in the diagnosis of MM and disease stages.
NLR, MLR, PLR, HB/RDW, IL-20, and VEGFA may be implicated in the inflammatory process of MM and renal impairment pathogenesis. NLR, MLR, and IL-20 can be used as prognostic markers in MM stages.
多发性骨髓瘤(MM)是一种恶性、不可治愈的疾病,其特征是单克隆浆细胞增多,并伴有肾功能损害。评估中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、血小板与淋巴细胞比值(PLR)、血红蛋白/红细胞分布宽度(HB/RDW)、白细胞介素-20(IL-20)和血管内皮生长因子-A(VEGFA)在伴有或不伴有肾功能损害的 MM 患者中的预后和严重程度指标。
对 60 例伴有肾功能损害的 MM 患者、60 例不伴有肾功能损害的 MM 患者和 60 例对照(对照组)进行了横断面研究。评估了全血细胞计数、IL-20 免疫测定以及 IL-20 和 VEGFA 的基因表达。
在 MM 患者中,尤其是在伴有肾功能损害的 MM 患者中,检测到 NLR、MLR 和 IL-20 水平升高,而 PLR、HB/RDW 水平降低,并且 IL-20 和 VEGFA 基因表达上调。NLR、MLR、PLR 和 IL-20 的受试者工作特征曲线分析显示,它们在 MM 和疾病分期的诊断中具有较高的灵敏度和特异性。
NLR、MLR、PLR、HB/RDW、IL-20 和 VEGFA 可能与 MM 及肾功能损害的发病机制中的炎症过程有关。NLR、MLR 和 IL-20 可作为 MM 分期的预后标志物。