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新诊断多发性骨髓瘤患者的实验室指标、遗传异常与分期的相关性分析。

Correlation analysis of laboratory indicators, genetic abnormalities and staging in patients with newly diagnosed multiple myeloma.

机构信息

Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Nanning, China.

Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning, China.

出版信息

Medicine (Baltimore). 2024 Nov 29;103(48):e40710. doi: 10.1097/MD.0000000000040710.

Abstract

To explore the correlation between immune status, genetic profile, laboratory parameters, and staging in patients with newly diagnosed multiple myeloma (NDMM) and to investigate the clinical characteristics of these patients along with their associated risk factors. The clinical data of 135 patients with multiple myeloma (MM) admitted to the First Affiliated Hospital of Guangxi Medical University between March 2020 and December 2023 were retrospectively collected. These data were systematically organized to evaluate the staging status of patients, including the Durie-Salmon, International Staging System, Revised International Staging System, and mSMART 3.0 staging systems. Additionally, the study included analysis of peripheral blood T-lymphocyte subpopulations and Fluorescence In Situ Hybridization results. Laboratory indices were collected at the initial diagnosis of patients with MM prior to any treatment. These data were subsequently analyzed to ascertain their significance in staging patients with multiple myeloma. Among 135 patients with MM, N-terminal pro-brain natriuretic peptide (NT-proBNP) and lambda light chain (λ light chain) levels were higher in patients with abnormal kidney function (P < .05). NT-proBNP and λ light chain levels can predict abnormal renal function in patients with NDMM. The λ light chain levels were significantly higher in Zhuang patients than in Han patients (P < .05). Patients with high staging differed in total T cell percentages, CD8+ cell percentages, T cells, CD3+/CD4-/CD8- double-negative cell percentages, CD8+T cells, age, NT-proBNP, and M protein levels (P < .05). In addition, M protein levels and age were positively correlated with CD4+T cells and negatively correlated with CD8+T cells (P < .05). CD8+ T cells, age, NT-proBNP, M protein level, and cytogenetic abnormalities represent distinct aspects of immune status, tumor load, and cytogenetic status at the initial diagnosis of patients. These indices are closely associated with the clinical stage of patients and can be combined to assess the clinical stage of multiple myeloma patients after admission to the hospital. Additionally, NT-proBNP and λ light chain levels play a role in predicting abnormal renal function in patients with NDMM.

摘要

目的

探讨初诊多发性骨髓瘤(NDMM)患者的免疫状态、基因谱、实验室参数与分期的相关性,并分析这些患者的临床特征及其相关危险因素。方法:回顾性收集 2020 年 3 月至 2023 年 12 月广西医科大学第一附属医院收治的 135 例多发性骨髓瘤患者的临床资料,对患者的分期状态进行评估,包括 Durie-Salmon、国际分期系统、修订的国际分期系统和 mSMART 3.0 分期系统。同时,分析外周血 T 淋巴细胞亚群和荧光原位杂交结果。采集患者初诊时的实验室指标,这些数据在患者接受任何治疗前进行分析,以确定其在多发性骨髓瘤患者分期中的意义。结果:在 135 例 MM 患者中,肾功能异常患者的 N 末端脑钠肽前体(NT-proBNP)和λ轻链(λ light chain)水平较高(P <.05)。NT-proBNP 和 λ light chain 水平可预测 NDMM 患者的肾功能异常。壮族患者的 λ light chain 水平明显高于汉族患者(P <.05)。高分期患者的总 T 细胞百分比、CD8+细胞百分比、T 细胞、CD3+/CD4-/CD8-双阴性细胞百分比、CD8+T 细胞、年龄、NT-proBNP 和 M 蛋白水平存在差异(P <.05)。此外,M 蛋白水平和年龄与 CD4+T 细胞呈正相关,与 CD8+T 细胞呈负相关(P <.05)。CD8+T 细胞、年龄、NT-proBNP、M 蛋白水平和细胞遗传学异常代表患者初诊时免疫状态、肿瘤负荷和细胞遗传学状态的不同方面,与患者的临床分期密切相关,可联合评估患者入院后的临床分期。此外,NT-proBNP 和 λ light chain 水平在预测 NDMM 患者肾功能异常方面具有一定作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08cc/11608745/82adfad27532/medi-103-e40710-g001.jpg

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