载脂蛋白A1对多发性骨髓瘤预后的影响  

The influence of apolipoprotein A1 on the prognosis of multiple myeloma

作　　者：沈静[1] 杨融辉[2] 张永超 廖爱军[1] 刘卓刚[1] 杨威[1] Shen Jing;Yang Ronghui;Zhang Yongchao;Liao Aijun;Liu Zhuogang;Yang Wei(Department of Hematology,Shengjing Hospital of China Medical University,Shenyang 110004,China;Department of Blood Transfusion,China Medical University First Hospital,Shenyang 110001,China;Hematology Laboratory,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院血液科,沈阳110004 [2]中国医科大学第一附属医院输血科,沈阳110001 [3]中国医科大学附属盛京医院血液研究室,沈阳110004

出　　处：《中华血液学杂志》2020年第8期675-679,共5页Chinese Journal of Hematology

摘　　要：目的探讨多发性骨髓瘤患者血清载脂蛋白A1水平的变化及其临床意义。方法统计412例多发性骨髓瘤患者的临床资料,以93名健康体检者为正常对照,使用SPSS 22.0进行数据分析。相关分析采用线性相关或Spearman秩相关系数。分析数据采用t检验、Mann-Whitney U检验或单因素方差分析。采用ROC曲线计算分界值,并与Kaplan-Meier生存分析进行比较。结果骨髓瘤组载脂蛋白A1水平低于正常对照组(0.89 g/L对1.24 g/L,P<0.05)。载脂蛋白A1水平随疾病的不同阶段动态变化,当疾病缓解时载脂蛋白A1水平可升高,疾病进展时载脂蛋白A1水平降低。多因素分析表明载脂蛋白A1减少是多发性骨髓瘤的独立危险因素。高载脂蛋白A1组与低载脂蛋白A1组的Kaplan-Meier生存分析显示高载脂蛋白A1组有更高的生存率和更长的无进展生存期。结论载脂蛋白A1是多发性骨髓瘤有效的肿瘤负荷标志物和预后因素。Objective In this study,we aimed to determine the change and clinical significance of serum level Apo A1 in MM patients.Methods In total,412 multiple myeloma patients were examined.SPSS 22.0 was used for data analysis.Correlation analysis was performed using linear correlation or Spearman rank correlation coefficients.Measurement data were analyzed with the t-test,Mann-Whitney U-test,or oneway analysis of variance(ANOVA).Used the ROC curve to calculate the cutoff value and compared the OS and PFS between high Apo A1 subgroup and low Apo A1 subgroup with Kaplan-Meier survival analysis.Results Our study showed that value of Apo A1 in the patient group was lower than that in the control group(0.89 g/L vs 1.24 g/L,P<0.05).We found that Apo A1 dynamically changed with different MM stages.As it was increased when the disease was in remission,and decreased after disease in progression.According the result of multivariate analysis Apo A1 reduction become the independent risk factors of MM.On the basis of Kaplan-Meier survival analysis between high Apo A1 subgroup and low Apo A1 subgroup,we found higher Apo A1 patienta had longer OS rate and PFS.Conclusions Apo A1 is a useful biomarker of tumor burden and a prognostic factor of multiple myeloma.

关 键 词：载脂蛋白A1 多发性骨髓瘤 肿瘤负荷 预后 

分 类 号：R733.3[医药卫生—肿瘤]