CD56与新诊断多发性骨髓瘤的预后关系分析  

The prognostic relationship between CD56 expression and newly diagnosed multiple myeloma

作　　者：耿传营[1] 杨光忠[1] 王慧娟[1] 周慧星[1] 张之尧 菅原[1] 陈文明[1] Geng Chuanying;Yang Guangzhong;Wang Huijuan;Zhou Huixing;Zhang Zhiyao;Jian Yuan;Chen Wenming(Department of Hematology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院血液科,北京100020

出　　处：《中华内科杂志》2022年第2期164-171,共8页Chinese Journal of Internal Medicine

摘　　要：目的评估骨髓瘤细胞CD56表达在新诊断多发性骨髓瘤(MM)患者中的预后价值。方法选择2011年1月1日至2021年1月1日在首都医科大学北京朝阳医院治疗的332例新诊断MM患者,中位年龄为60岁,男女比例为1.2∶1,所有患者在诱导治疗前均利用流式细胞术的方法检测骨髓瘤细胞表面CD56的表达,分析骨髓瘤细胞CD56表达与新诊断MM总生存期(overall survival,OS)和无进展生存期(progression-free survival,PFS)的关系。为平衡CD56阳性和阴性患者之间预后因素的分布,降低混杂因素对研究对象和结局关系的干扰,利用倾向性评分匹配技术按照1∶1比例匹配CD56阳性和阴性MM患者,用于平衡不同组别之间预后因素的分布。结果在332例患者中,216例(65.1%)患者的骨髓瘤细胞检测到CD56表达。与CD56阴性患者相比,CD56阳性患者的OS(58.4比43.1个月,P=0.024)和PFS(28.7比24.1个月,P=0.013)均明显延长。单因素Cox比例风险回归分析显示,CD56表达与更长的OS(HR=0.644,95%CI 0.438~0.947,P=0.025)及更长的PFS有关(HR=0.646,95%CI 0.457~0.913,P=0.013)。多因素分析同样证实了CD56表达是PFS的有利因素(HR=0.705,95%CI 0.497~0.998,P=0.049),但对OS却无明显影响(P>0.05)。倾向性评分匹配分析共筛选出194例患者,每组97例,CD56阳性患者PFS较长(34.2比25.1个月,P=0.047),但OS差异无统计学意义(63.4比43.1个月,P=0.056)。结论新诊断MM患者CD56表达是PFS的有利预后因素。Objective To evaluate the prognostic value of CD56 expression in newly diagnosed MM(NDMM).Methods A total of 332 NDMM patients were enrolled in Beijing Chaoyang Hospital,Capital Medical University from January 1,2011 to January 1,2021,with a median age of 60 years and a male to female ratio of 1.2∶1.CD56 expression on myeloma cells was detected by flow cytometry before induction therapy.Overall survival(OS)and progression-free survival(PFS)data were collected.In order to reduce the confounding factors,the propensity score matching technique was used to match CD56 positive versus negative patients at a ratio of 1∶1.Results Among 332 patients,CD56 positivity rate was 65.1%(216/332).Patients with CD56 expression had significantly longer median OS(58.4 vs.43.1 months,P=0.024)and PFS(28.7 vs.24.1 months,P=0.013)than those with negative CD56.Univariate Cox proportional hazards regression analyses showed that CD56 expression was positively correlated with OS(HR=0.644,95%CI 0.438-0.947,P=0.025)and a favorable prognostic factor for PFS(HR=0.646,95%CI 0.457-0.913,P=0.013).The favorable effect of CD56 expression on PFS was confirmed in multivariate analysis(HR=0.705,95%CI 0.497-0.998,P=0.049),but OS was not affected(P>0.05).In the propensity score matching analysis,194 patients with 97 in each group were identified.CD56 positivity consistently predicted longer PFS(34.2 vs.25.1 months,P=0.047),but not OS(63.4 vs.43.1 months,P=0.056).Conclusion These results demonstrate that CD56 expression is a favorable prognostic factor for PFS of newly diagnosed MM patients.

关 键 词：多发性骨髓瘤 CD56 存活率分析 预后 

分 类 号：R733.3[医药卫生—肿瘤]