摘要
目的:探讨Ⅺ型胶原α1(COL11A1)在多发性骨髓瘤中的表达及与患者预后的关系。方法:收集2012年1月至2018年3月初诊于本院小于65岁的多发性骨髓瘤患者100例为多发性骨髓瘤组,选择与其一般资料相匹配的50例健康骨髓捐献者作为对照组。采集受试者骨髓并分离单个核细胞,采用qRT-PCR法检测骨髓单个核细胞中COL11A1mRNA水平;采用Western Blot法检测骨髓单个核细胞中COL11A1蛋白表达水平;收集患者临床病理资料,分析COL11A1表达水平与多发性骨髓瘤患者临床病理学指标的关系;对患者随访3年,利用Kaplan-Meier法分析不同COL11A1表达水平与患者3年累积生存率的关系;通过单因素和多因素COX回归分析影响多发性骨髓瘤患者预后的危险因素。结果:多发性骨髓瘤组患者骨髓单个核细胞中COL11A1mRNA和蛋白表达水平均高于对照组,差异有统计学意义(P<0.05);多发性骨髓瘤患者骨髓单个核细胞中COL11A1表达与性别、免疫球蛋白分型、轻链类型、血钙水平、血红蛋白水平、血肌酐水平、染色体状态无关,差异无统计学意义(P>0.05),与D-S分期、β2-微球蛋白水平、LDH水平、血清白蛋白水平有关,差异有统计学意义(P<0.05);Kaplan-Meier分析结果显示,COL11A1高表达组患者3年累积生存率(46.57%)显著低于低表达组(80.00%),差异有统计学意义(对数秩χ2=4.995,P=0.025);COX回归分析结果显示,COL11A1表达水平、D-S分期、ISS分期、β2-微球蛋白水平、血清白蛋白水平是影响患者预后的主要因素,差异有统计学意义(P<0.05),其中COL11A1高表达、D-S分期为Ⅱ+Ⅲ、ISS分期为Ⅱ+Ⅲ、β2-微球蛋白>3.5mg/L、血清白蛋白>35g/L是影响多发性骨髓瘤患者预后的危险因素,差异有统计学意义(P<0.05)。结论:COL11A1在多发性骨髓瘤患者骨髓单个核细胞中呈高表达,其表达水平与患者预后密切相关。
Objective:To investigate the expression of collagen type Ⅺ α1 chain(COL11 A1) in multiple myeloma and its relationship with the prognosis of patients.Methods:100 multiple myeloma patients who were diagnosed in hospital during January 2012 to March 2018 and were younger than 65 years old were collected as the multiple myeloma group, and other 50 healthy bone marrow donors matching their general data were selected as the control group.The bone marrow of subjects was collected, and mononuclear cells were separated;qRT-PCR method was used to detect the level of COL11 A1 mRNA in bone marrow mononuclear cells;Western Blot was used to detect the expression level of COL11 A1 protein in bone marrow mononuclear cells;the clinical pathological data of patients were collected and the relationship between COL11 A1 expression level and clinicopathological indicators of multiple myeloma patients was analyzed;the patients were followed up for 3 years.The Kaplan-Meier method was used to analyze the relationship between different COL11 A1 expression levels and 3-year cumulative survival rate of patients;and univariate and multiva-riate COX regression analyses were used to analyze the risk factors that affected the prognosis of multiple myeloma patients.Results:The expression levels of COL11 A1 mRNA and protein in bone marrow mononuclear cells of patients in the multiple myeloma group were higher than that in the control group, and the difference was statistically significant(P<0.05);the expression of COL11 A1 in bone marrow mononuclear cells of patients with multiple myeloma had nothing to do with gender, immunoglobulin typing, light chain types, blood calcium level, hemoglobin level, blood creatinine level and chromosome status(P>0.05),but it was related to D-S staging, β2-microglobulin level, LDH level and serum albumin level(P<0.05).Kaplan-Meier analysis showed that the 3-year cumulative survival rate of patients in the COL11 A1 high expression group(46.57%) was significantly lower than that in the low expression group(80.0
作者
张永梅
张志敏
周洁
潘志兰
冯丽倩
杨彦
ZHANG Yongmei;ZHANG Zhimin;ZHOU Jie;PAN Zhilan;FENG Liqian;YANG Yan(Department of Hematology,Shijiazhuang People's Hospital,Shijiazhuang 050000,China)
出处
《中国中医骨伤科杂志》
CAS
2022年第8期56-60,共5页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
河北省卫生健康委员会资助项目(20210067)
石家庄市卫生和计划生育委员会资助项目(20160803)。
