摘要
目的分析伴肾损害多发性骨髓瘤(MM)患者染色体异常与临床指标的相关性。方法选取2015年1月至2020年12月本院血液内科和肾内科收治的60例伴肾损害MM患者作为研究对象,均采用荧光原位杂交(FISH)技术检测染色体,分析染色体异常情况。比较染色体正常与染色体异常患者临床指标[血小板计数(PLT)、血红蛋白(Hb)、白蛋白(ALB)、球蛋白(GLB)、红细胞沉降率(ESR)、骨髓浆细胞数、M蛋白],分析染色体异常与临床指标的相关性。结果60例伴肾损害MM患者中,染色体正常20例,占比33.33%;异常40例,占比66.67%,其中免疫球蛋白重链(IGH)重排16例,占比40.00%;1q21扩增12例,占比30.00%;RB-1基因缺失8例,占比20.00%;p53缺失4例,占比10.00%。染色体异常患者PLT、Hb、GLB、ESR水平均低于染色体正常患者,骨髓浆细胞数多于染色体正常患者,M蛋白水平高于染色体正常患者,差异有统计学意义(P<0.05);染色体正常与染色体异常患者ALB水平比较差异无统计学意义。Spearman相关性分析显示,P53缺失与PLT、GLB、ALB、M蛋白水平呈正相关(r>0,P<0.05);IGH重排与ALB呈正相关(r>0,P<0.05);RB-1缺失与Hb、ALB呈负相关(r<0,P<0.05),与GLB、ESR、M蛋白呈正相关(r>0,P<0.05);1q21扩增与临床指标无关。结论伴肾损害MM患者染色体异常较多见,主要表现为PLT、Hb、GLB、ESR水平降低,骨髓浆细胞数、M蛋白水平升高;不同染色体异常与临床指标存在一定相关性,初诊行染色体检查可为预后判断提供更多分子遗传学信息。
Objective Correlation analysis of chromosomal abnormalities with clinical indicators in patients with multiple myeloma(MM)with renal damage.Methods 60 patients with MM with renal impairment admitted to the department of Hematology and Nephrology of our hospital from January 2015 to December 2020 were selected as the study subjects,all of whom were tested for chromosomal abnormalities used fluorescence in si-tu hybridization(FISH)technique,the characteristics of chromosome abnormality were analyzed.The clinical indicators(platelet count[PLT],he-moglobin[Hb],albumin[ALB],globulin[GLB],erythrocyte sedimentation rate[ESR],bone marrow plasma cell count,M protein)of patients with normal and abnormal chromosomes were compared,and the correlation between chromosome abnormalities and clinical indicators was analyzed.Results Among 60 patients with MM with renal damage,20 cases had normal chromosomes,accounting for 33.33%;40 cases with abnormal chro-mosomes,accounting for 66.67%,among which 16 cases with immunoglobulin heavychain variable region(IGH)rearrangement,accounting for 40.00%;12 cases with 1q21 deletion,accounting for 30.00%;8 cases with RB-1 gene deletion,accounting for 20.00%;4 cases with p53 deletion,ac-counting for 10.00%.The levels of PLT,Hb,GLB and ESR in patients with chromosomal abnormal were lower than those in patients with chromo-somal normal,and the bone marrow plasma cell count was more than that in patients with chromosomal normal,M protein level were higher than that in patients with chromosomal normal,the differences were statistically significant(P<0.05);there was no significant difference in the levels of ALB between patients with normal and abnormal chromosomes.Spearman correlation analysis showed that p53 deletion was positively correlated with the levels of PLT,GLB,ALB and M protein(r>0,P<0.05);IGH rearrangement was positively correlated with ALB(r>0,P<0.05);RB-1 de-letion was negatively correlated with Hb and ALB(r<0,P<0.05)and positively correlated with GLB,ESR,and M protein(r>0,P<0.05);1q21
作者
谢将
王英
胡婷
XIE Jiang;WANG Ying;HU Ting(Department of Hematology,Ji'an Central People's Hospital,Ji'an,Jiangxi,343000,China)
出处
《当代医学》
2023年第4期104-107,共4页
Contemporary Medicine
基金
吉安市指导性科技计划项目[吉市科技字【2021】8号(5-44)]。
关键词
多发性骨髓瘤
肾损害
染色体异常
相关性
Multiple myeloma
Renal damage
Chromosomal abnormalities
Correlation
