血清LDH和β2-MG水平与多发性骨髓瘤患者预后的相关性  

Correlation between Serum LDH,β2-MG Levels and Prognosis in Patients withMultiple Myeloma

作　　者：韩少玲[1] 吴亚兵[1] 张家友[1] 陈丽娟[1] HAN Shaoling;WU Yabing;ZHANG Jiayou(416 Hospital of Nuclear Industry,Chengdu,610000)

机构地区：[1]核工业四一六医院,610000

出　　处：《实用癌症杂志》2020年第11期1817-1820,1825,共5页The Practical Journal of Cancer

摘　　要：目的探究血清乳酸脱氢酶(LDH)、β2-微球蛋白(β2-MG)水平与多发性骨髓瘤(MM)患者预后的相关性。方法选择67例初诊MM患者及100例健康志愿者分别纳入MM组及对照组。测定受试者血清LDH、β2-MG水平,收集MM患者临床资料。结果①MM组血清β2-MG、LDH水平均高于对照组,差异具统计学意义(P<0.05)。②有重度贫血、骨髓浆细胞比例>30%、体力状态(ECOG)评分>3分、DS分期为Ⅲ期患者血清LDH和β2-MG水平显著高于无重度贫血、骨髓浆细胞≤30%、ECOG评分≤3分、DS分期为Ⅰ~Ⅱ期的患者(P<0.05)。③入组患者均获得随访,随访时间为6~70个月,中位随访时间42个月。Kaplan-Meier生存曲线及Log-rank检验示,LDH高值组(LDH>245 U/l)患者总体生存率低于LDH低值组(LDH≤245 U/l)(P<0.05);β2-MG高值组(β2-MG>5.5 mg/l)患者总体生存率低于β2-MG低值组(β2-MG≤5.5 mg/l)(P<0.05)。④COX多因素分析示,合并重度贫血、DS分期为Ⅲ期、LDH>245 U/l、β2-MG>5.5 mg/l是MM患者预后不良的独立危险因素(P<0.05)。结论MM患者可伴有血清LDH及β2-MG水平的显著升高,且其水平与患者病情严重程度及预后相关,临床上可将其作为预测患者预后的参考指标。Objective To explore correlation between serum lactate dehydrogenase(LDH),β2-microglobulin(β2-MG)levels and prognosis in patients with multiple myeloma(MM).Methods 67 patients newly diagnosed with MM and 100 healthy volunteers were enrolled as MM group and the control group,respectively.The levels of serum LDH andβ2-MG were measured.The clinical data of MM patients were collected.Results①The levels of serumβ2-MG and LDH in MM group were higher than those of the control group(P<0.05).②The levels of serum LDH andβ2-MG in patients with severe anemia,bone marrow plasmacyte ratio higher than 30%,physical status(ECOG)score higher than 3 points,DS staging at stageⅢwere significantly higher than those with no severe anemia,bone marrow plasmacyte ratio not higher than 30%,ECOG score not higher than 3 points and DS staging at stageⅠ~Ⅱ(P<0.05).③All patients were followed up for 6 to 70 months,with median follow-up time of 42 months.Kaplan-Meier survival curve and Log-rank test showed that overall survival rate in high LDH group(LDH less than 245 U/l)was lower than that in low LDH group(LDH not less than 245 U/l)(P<0.05).The overall survival rate in highβ2-MG group(β2-MG higher than 5.5mg/l)was lower than that in lowβ2-MG group(β2-MG not higher than 5.5 mg/l)(P<0.05).④COX multivariate analysis showed that severe anemia,DS staging at stage III,LDH higher than 245 U/l andβ2-MG higher than 5.5 mg/l were independent risk factors for poor prognosis of MM patients(P<0.05).Conclusion The levels of serum LDH andβ2-MG are significantly increased in MM patients.And their levels are related to disease severity and prognosis of patients.Clinically,they can be applied as reference indexes for predicting prognosis.

关 键 词：乳酸脱氢酶 Β2-微球蛋白 多发性骨髓瘤 预后 

分 类 号：R733.3[医药卫生—肿瘤]