多发性骨髓瘤患者血清可溶性PD-L1水平在辅助诊断及临床分型的价值研究  

Value of Blood Soluble PD-L1 in the Auxiliary Diagnosis and Clinical Subtype of Multiple Myeloma

作　　者：何进 张艳[2] 申娴娟[3] 鞠少卿[2] HE Jin;ZHANG Yan;SHEN Xian-juan;JU Shao-qing(Hangzhou Yuhang Jiamu Nursing Home,Hangzhou 310000,China;Center of Laboratory Medicine,Affiliated Hospital of Nantong University,Jiangsu Nantong 226001,China;Research Center of Clinical Medicine,Affiliated Hospital of Nantong University,Jiangsu Nantong 226001,China)

机构地区：[1]杭州余杭嘉木护理院,杭州310000 [2]南通大学附属医院医学检验中心,江苏南通226001 [3]南通大学附属医院临床医学研究中心,江苏南通226001

出　　处：《现代检验医学杂志》2021年第2期15-18,110,共5页Journal of Modern Laboratory Medicine

基　　金：国家自然科学基金面上项目(NO.81271920)。

摘　　要：目的探讨多发性骨髓瘤(multiple myeloma,MM)患者血液可溶性程序性死亡受体-1(soluble programmed death-ligand 1,sPD-L1)表达及临床意义。方法选取MM患者65例(MM组),健康体检者65例(对照组);酶联免疫吸附测定法(ELISA)检测sPD-L1表达量;采用受试者工作特征(receiver operator characteristic curve,ROC)曲线评估各指标单独及联合检测对MM的诊断效能。结果MM组和对照组sPD-L1表达量分别为1.330(0.482,3.000)ng/ml和0.310(0.280,0.360)ng/ml,MM患者显著高于健康对照者,差异有统计学意义(P<0.05);ISS-II期患者sPD-L1表达水平高于ISS-I期(P<0.05),ISS-III期患者sPD-L1水平高于ISS-II期患者(P<0.05);sPD-L1表达水平与β_(2)微球蛋白(β_(2)-microglobulin,β_(2)M)相关(P=0.033);sPD-L1曲线下面积(AUC)为0.789,高于β_(2)M,λ轻链和κ轻链。sPD-L1诊断MM的灵敏度最高,sPD-L1,λ轻链和β_(2)M单独或者联合应用得到较理想的诊断效能。结论MM患者sPD-L1表达水平增高,检测sPD-L1水平变化可用于MM的辅助诊断及临床分型。Objective To investigate the expression level and clinical value of sPD-L1 in multiple myeloma(MM).Methods 65 MM patients(MM group)and 65 healthy controls(control group)were selected.The expression of sPD-L1 was detected by ELISA.The receiver operator characteristic curve(ROC)was used to evaluate the diagnostic efficacy of each indicator alone and combined detection on MM.Results The relative expression levels of sPD-L1 in MM group and control group were1.330(0.482,3.000)ng/ml and 0.310(0.280,0.360)ng/ml,respectively,and MM group was significantly higher than the control group.The levels of sPD-L1 were significantly higher in ISS-II MM patients than ISS-I patients,the difference was statistically significant(P<0.05).And the levels of sPD-L1 were higher in ISS-III patients than ISS-II patients(P<0.05).The expression levels of sPD-L1 were significantly correlated withβ_(2)-microglobulin(β_(2)M)(P=0.033).The area under the curve(AUC)of sPD-L1 was 0.789,which higher than that ofβ_(2)M,λlight chain andκlight chain.The diagnostic sensitivity of sPD-L1 was highest.sPD-L1,λlight chain orβ_(2)M was used alone or in combination to obtain better diagnostic efficiency.Conclusion The sPD-L1 level was increased in MM patients,and the detection of sPD-L1 level changes can be used for the auxiliary diagnosis and clinical subtype of MM.

关 键 词：多发性骨髓瘤 可溶性程序性死亡受体-1 受试者工作特征曲线 

分 类 号：R733.3[医药卫生—肿瘤] R730.43[医药卫生—临床医学]