摘要
目的探讨1q21扩增和血清白细胞介素⁃21(IL⁃21)、乳酸脱氢酶(LDH)与多发性骨髓瘤患者(MM)疗效及预后的关系。方法选取2017年10月至2023年6月期间滁州市第一人民医院血液科收治的MM患者共计162例,依据MM疗效标准将患者分为有效组113例、无效组49例。比较两组的血清IL⁃21、LDH水平及1q21扩增阳性率;并采用Spearman及kendall相关系数分析IL⁃21、LDH及1q21扩增与MM患者疗效的关系。对病情缓解出院的患者随访至2023年12月,并根据随访情况分为预后良好组(n=64)、预后不良组(n=98)。比较两组的一般资料及实验室相关指标,采用多因素Logistic分析1q21扩增、血清IL⁃21以及LDH与MM患者预后的相关性,绘制受试者工作特性曲线(ROC)评估血清IL⁃21、LDH二者联合检测对MM患者预后的预测价值。结果无效组血清IL⁃21、LDH水平以及1q21扩增阳性率均明显高于有效组,差异有统计学意义(χ^(2)/t=11.953、11.116、39.329,均P<0.05);MM患者疗效与血清IL⁃21、LDH水平以及1q21扩增阳性率均呈显著负相关(r=-0.613、-0.294、-0.572,均P<0.05);多因素回归分析显示,年龄>60、合并淀粉样变、1q21扩增、血清IL⁃21以及LDH表达水平的升高均为影响MM患者预后的独立危险因素(P<0.05);ROC曲线显示,血清IL⁃21以及LDH以及二者联合检测的ROC面积分别为0.785、0.781以及0.849(均P<0.05)。结论1q21扩增、血清IL⁃21、LDH水平高表达均可能影响MM患者疗效,且血清IL⁃21以及LDH二者联合检测对于MM患者的预后评估具备较高价值。
Objective To explore the relationship between 1q21 amplification,serum IL⁃21,LDH and MM efficacy and prognosis.Methods A total of 162 MM patients admitted to the Hematology De⁃partment of Chuzhou First People's Hospital from October 2017 to June 2023 were selected.According to the efficacy criteria of MM,the patients were divided into an effective group of 113 cases and an ineffective group of 49 cases.Serum IL⁃21,LDH levels and 1q21 amplification positive rate were compared between the two groups.Spearman and kendall correlation coefficients were used to analyze the relationship between IL⁃21,LDH and 1q21 amplification and the efficacy of MM patients.Patients in remission were followed up until De⁃cember 2023,and were divided into good prognosis group(n=64)and poor prognosis group(n=98).The general data and relevant laboratory indicators of the two groups were compared,and the correlation between 1q21 amplification,serum IL⁃21 and LDH and the prognosis of MM patients was analyzed by multivariate Lo⁃gistic analysis.The predictive value of serum IL⁃21 and LDH combined detection in MM patients was evalu⁃ated by ROC.Results The levels of IL⁃21,LDH and the positive rate of 1q21 amplification in the ineffec⁃tive group were significantly higher than those in the effective group,with statistical significance(χ^(2)/t=11.953,11.116,39.329,all P<0.05).The efficacy of MM patients was negatively correlated with serum IL⁃21,LDH levels and 1q21 amplification positive rate(r=-0.613,-0.294,-0.572,all P<0.05).Multivariate regres⁃sion analysis showed that age>60,combined amyloidosis,1q21 amplification,elevated serum IL⁃21 and LDH expression levels were independent risk factors for the prognosis of MM patients(P<0.05).ROC curve showed that the ROC areas of serum IL⁃21 and LDH and their combined detection were 0.785,0.781 and 0.849,respectively(all P<0.05).Conclusion The amplification of 1q21 and the high expression of serum IL⁃21 and LDH may affect the efficacy of MM patients,and the combined detect
作者
徐士云
凌春
金其川
XU Shiyun;LING Chun;JIN Qichuan(Department of Hematology,Chuzhou First People's Hospital,Anhui Medical University,Chuzhou,Anhui,China,239000)
出处
《分子诊断与治疗杂志》
2024年第8期1587-1590,1595,共5页
Journal of Molecular Diagnostics and Therapy
基金
安徽省卫生健康委科研项目(AHWJ2021b005)。
