监测可溶性尿激酶型纤溶酶原激活物受体在预测多发性骨髓瘤患者髓外浸润及预后中的作用  

Monitoring of suPAR for predicting extramedullary involvement and prognosis in multiple myeloma

作　　者：沈杰[1] 王娟[1] 潘崚 赵芳[1] 苏国宏[1] 王庆[1] 王瑞环[1] 张敏娟[1] 刘春燕[1] 张睿[1] 

机构地区：[1]沧州市中心医院血液内科,河北沧州061000 [2]河北医科大学第二医院

出　　处：《临床血液学杂志》2011年第2期168-170,共3页Journal of Clinical Hematology

摘　　要：目的:探讨血清可溶性尿激酶型纤溶酶原激活物受体(soluble urokinase-type plasminogen activatorreceptor,suPAR)在多发性骨髓瘤(MM)患者血清中的表达、该数值与疾病预后相关因素(分期、年龄、髓外浸润、染色体异常、肾功能、C-反应蛋白、β2-MG等)的关系及其在预测疾病预后方面的临床意义。方法:采用酶联免疫吸附的方法检测40例MM患者和30例正常对照血清suPAR表达水平。结果:①无效组与缓解组、进步组血清suPAR表达比较差异有统计学意义(P<0.05);②生存期<2年组血清suPAR表达高于生存期>2年组(P<0.01);③除血红蛋白数值高低与suPAR数值无相关性外,分期、肾功能异常、C反应蛋白、β2微球蛋白、髓外浸润各组血清suPAR值均差异有统计学意义(均P<0.05);④应用logistic回归对诸因素与患者生存期间的关系进行分析,表明疾病分期、suPAR表达水平高是导致患者生存期不足2年的独立因素。结论:suPAR水平增高与MM疾病进展、生存期缩短、早期出现髓外浸润等因素有关,提示预后不良。Objective：To explore the expression of soluble urokinase-type plasminogen activator receptor（suPAR） in multiple myeloma（MM） patients,the co-relationship of suPAR with prognosis factors（stage,age,extramedullary infiltration,chromosome abnormalities,kidney function,CRP,β2-MG and etc.）.Method：We used enzyme-linked immunosorbent assay to determine the levels of suPAR of 40 patients with MM and 30 healthy persons as control group.Result：①The suPAR levels were significantly different（P0.05） among the non-response group,complete remission group and the progression group.②The suPAR expression of the group with the 2-year suvival was higher than that of the group with 2-year suvival（P0.01）.③Stage,kidney,CRP,β2-MG and extramedullary infiltration led to distinctly statistical deviation in serum suPAR expression（P0.05）,except the hemalbumen level.④ By analyzing the co-relationship of all the factors with logistic regression,it was proved that disease staging and suPAR expression were the independent factors to suvival less than 2 years.Conclusion：The high suPAR expression is related with disease progression,shortened survival and extramedullary infiltration,which indicates poor prognosis.

关 键 词：多发性骨髓瘤 纤溶酶原激活物受体 尿激酶型 可溶性 CD87 

分 类 号：R733.3[医药卫生—肿瘤]