多发性骨髓瘤患者血清sIL-2R表达情况与患者预后的关系

The Relationship between Serum sIL-2R Expression and Prognosis in Patients with Multiple Myeloma

摘要

目的 探究多发性骨髓瘤(MM)患者血清sIL-2R表达情况与患者预后的关系。方法 选取开封市人民医院2018年3月~2020年7月收治的72例MM患者作为研究对象,根据预后情况将72例MM患者分为存活组、死亡组,分析MM患者死亡的危险因素,绘制受试者工作特征曲线（ROC）判断发生死亡时血清sIL-2R最佳截断值,根据线下面积评估血清sIL-2R表达水平与患者预后的关系。结果 随访3年中,72例MM患者存活45例（62.50%）,死亡27例（37.50%）。死亡组MM分期III期人数比例高于存活组,β₂-微球蛋白水平（β₂-MG）、血清钙（Ca）水平、sIL-2R水平及轻链比值（K/λ）,高于存活组,差异有统计学意义（P<0.05）。Logistic多因素回归分析结果显示,MM分期、β₂-MG、Ca、sIL-2R水平及K/λ值,均为MM患者死亡的危险因素（P<0.05）。ROC曲线显示,MM患者最佳截断值为328.50,曲线下面积为0.903,灵敏度为86.75%,特异度为88.75%,95% CI（1.27~3.01）,提示血清sIL-2R水平可用于预测MM患者的预后情况。结论 sIL-2R水平对MM患者的预后有着重要的预测价值,MM分期、β₂-MG、Ca水平及K/λ值,均为MM的危险因素。

Abstract

Objective To explore the relationship between serum sIL-2R expression and patient prognosis in patients with multiple myeloma. Methods The 72 MM patients admitted from March 2018 to July 2020 were selected as the study object, and 72 MM patients were divided into survival group and death group according to the prognosis. The risk factors of death of MM patients were analyzed, the optimal cutoff of serum sIL-2R at the time of death, and the relationship between sIL-2R expression level and patient prognosis was evaluated. Results After 3 years of follow-up, 45 of 72 MM patients survived and 27 died, the mortality rate was 37.50% and the survival rate was 62.50%. The proportion of MM stage III was higher than the surviving group, and β₂-microglobulin level (β₂-MG), serum calcium (Ca) level, sIL-2R level and light chain ratio (K/λ) were higher than the surviving group, showing a statistically significant difference (P<0.05). Logistic Multivariate regression analysis, the results showed that MM stage, β₂-MG, Ca, sIL-2R level, and K/λ values were all risk factors for death in MM patients (P<0.05). The ROC curve showed that the optimal cut-off value of MM patients was 328.50, the area under the curve was 0.903, the sensitivity was 86.75%, the specificity was 88.75%, and 95% CI (1.27~3.01), suggesting that serum sIL-2R levels can be used to predict the prognosis of MM patients. Conclusion The sIL-2R level has an important predictive value for the prognosis of MM patients. MM stage, β₂-MG, Ca level and K / λ value are all risk factors for MM..

关键词

多发性骨髓瘤 / 血清sIL-2R表达情况 / 预后关系

Key words

multiple myeloma / serum sIL-2R expression / prognostic relationship

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