中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值对初诊多发性骨髓瘤患者总生存和无进展生存的预测意义  

Prognostic value of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio for newly diagnosed multiple myeloma

作　　者：崔壮壮 张媛媛[2] 金北平[2] 魏长荣[2] 王春芝 隋金才[2] 王超[2] 张海燕[2] CUI Zhuangzhuang;ZHANG Yuanyuan;JIN Beiping;WEI Changrong;WANG Chunzhi;SUI Jincai;WANG Chao;ZHANG Haiyan(Qingdao University, Qingdao 266000, Shandong Province, China;Department of Hematology, Linyi People's Hospital, Linyi 276000, Shandong Province, China)

机构地区：[1]青岛大学,山东青岛266000 [2]临沂市人民医院血液科,山东临沂276000

出　　处：《解放军医学院学报》2019年第2期121-126,共6页Academic Journal of Chinese PLA Medical School

基　　金：山东省自然科学基金(ZR2014HL033;ZR2018PH014);山东省医药卫生科技发展计划项目(2017WS133);山东省中医药科技发展计划项目(2017-472);医学科学研究基金资助项目(YWJKJJHKYJ-B17123-Q3)~~

摘　　要：目的分析中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)和血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)对初诊多发性骨髓瘤(multiple myeloma,MM)患者总生存时间和无进展生存时间的影响。方法回顾性分析2015年1月-2018年8月临沂市人民医院血液科收治的128例MM患者临床资料。将MM患者分为低NLR组(NLR <2.444)和高NLR组(NLR≥2.444),低PLR组(PLR <145.234)和高PLR组(PLR≥145.234)。分析比较患者临床资料与总生存时间和无进展生存时间的关系。结果高NLR组48例,低NLR组80例。高NLR组患者肌酐、血清钙、β2-MG指标显著高于低NLR组(P均<0.05)。高PLR组41例,低PLR组87例。高PLR组患者血清白蛋白、β2-MG指标显著高于低PLR组(P均<0.05)。单因素分析显示,血清钙、血肌酐、血清白蛋白、β2-MG、NLR、PLR与总生存时间有关,β2-MG、NLR、PLR与无进展生存时间有关。多因素分析显示,NLR是MM患者无进展生存时间的独立预后因素(HR:0.444,95%CI:0.200～0.986)。结论初诊多发性骨髓瘤患者的NLR可作为无进展生存时间的独立预后因素,NLR较高预示着较短的无进展生存时间。Objective To explore the predictive value of neutrophil/lymphocyte ratio(NLR) and platelet/lymphocyte ratio(PLR)for overall survival and progression free survival in patients with newly diagnosed multiple myeloma. Methods Clinical data about 128 patients with multiple myeloma who were diagnosed in Linyi People’s Hospital from January 2015 to August 2018 were retrospectively analyzed. The patients were divided into low NLR group(NLR < 2.444) versus high NLR group(NLR ≥ 2.444),low PLR group(PLR < 145.234) versus high PLR group(PLR ≥ 145.234). Chi-square test was used to analyze the relationship between NLR, PLR and clinical data. The relationships of NLR and PLR with overall survival(OS) and progression-free survival(PFS) were analyzed by univariate and multivariate Cox regression. Results There were 48 cases in the high NLR group and 80 cases in the low NLR group. Compared to low NLR group, the high NLR group had higher level of creatinine, serum calcium and serum β2 microglobulin(all P < 0.05). There were 41 cases in the high PLR group and 87 cases in the low PLR group. Compared with the low PLR group, the levels of serum albumin and serum β2 microglobulin were signi?cantly higher in the high PLR group(all P < 0.05).Univariate analysis showed that serum calcium, serum creatinine, serum albumin,β2-MG, NLR, and PLR were the influential factors of overall survival, and β2-MG, NLR, and PLR were the influential factors of progression-free survival.Multivariate analysis showed that NLR was an independent prognostic factor affecting progression-free survival in MM patients(HR, 0.444;95% CI, 0.200-0.986). Conclusion NLR in patients with newly diagnosed multiple myeloma can be an independent prognostic factor for progression-free survival. Higher NLR predicts shorter progression-free survival.

关 键 词：多发性骨髓瘤 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 总生存时间 无进展生存时间 

分 类 号：R733.3[医药卫生—肿瘤]