血清sCD54、presepsin水平对多发性骨髓瘤的诊断价值及与患者预后的关系  

Diagnostic value of serum sCD54 and presepsin levels in multiple myeloma and their relationship with prognosis of patient

作　　者：左立辉[1] 李四强[1] 秦伟[1] 韩红满 ZUO Lihui;LI Siqiang;QIN Wei;HAN Hongman(Department of Hematology and Endocrinology,the 82nd Army Hospital of the Chinese People′s Liberation Army,Baoding,Hebei 071000,China)

机构地区：[1]中国人民解放军陆军第八十二集团军医院血液内分泌科,河北保定071000

出　　处：《国际检验医学杂志》2022年第9期1124-1128,共5页International Journal of Laboratory Medicine

摘　　要：目的探讨血清可溶性CD54(sCD54)、可溶性CD14分子亚型(presepsin)水平对多发性骨髓瘤的诊断价值及与患者预后的关系。方法选取2017年3月至2019年2月在中国人民解放军陆军第八十二集团军医院就诊住院的多发性骨髓瘤患者118例作为病例组,另选取同期该院体检健康者80例作为对照组。检测两组血清sCD54、presepsin水平;通过绘制受试者工作特征(ROC)曲线分析sCD54、presepsin对多发性骨髓瘤的诊断价值,采用多因素Logistic回归分析探讨影响多发性骨髓瘤患者预后的相关因素。结果病例组血清sCD54、presepsin水平均高于对照组(P<0.05)。多发性骨髓瘤患者中,预后良好98例,预后不良20例。预后良好患者血清sCD54、presepsin水平低于预后不良患者(P<0.05)。血清sCD54、presepsin水平与年龄、国际分期体系(ISS分期)严重程度、Ca^(2+)、β_(2)-微球蛋白均呈正相关(r=0.426~0.723,P<0.05),与C反应蛋白呈负相关(r=-0.572、-0.683,P<0.05)。血清sCD54、presepsin单项及二者联合检测诊断多发性骨髓瘤的ROC曲线下面积(AUC)分别为0.784(95%CI:0.713~0.857)、0.674(95%CI:0.568~0.763)、0.832(95%CI:0.783~0.881)。当sCD54为310 ng/mL时,诊断多发性骨髓瘤的灵敏度为75.5%,特异度为81.3%;当presepsin为280 pg/mL时,诊断多发性骨髓瘤的灵敏度为67.2%,特异度为68.4%;二者联合检测诊断多发性骨髓瘤的灵敏度为80.5%,特异度为91.2%。多因素Logistic回归分析结果显示,sCD54、presepsin水平升高均是多发性骨髓瘤患者预后不良的独立危险因素(P<0.05)。结论多发性骨髓瘤患者血清sCD54、presepsin水平明显升高,二者对多发性骨髓瘤具有一定的诊断价值,联合检测诊断价值更高,血清sCD54、presepsin水平升高均是多发性骨髓瘤患者预后不良的独立危险因素,二者有助于早期识别评估疾病的严重程度,有望作为多发性骨髓瘤早期的分子生物标志物。Objective To investigate the diagnostic value of serum soluble CD54(sCD54)and presepsin levels in multiple myeloma and their relationship with prognosis of patient.Methods A total of 118 patients with multiple myeloma who were hospitalized in the 82nd Army Hospital of the People′s Liberation Army from March 2017 to February 2019 were collected as the case group,and 80 healthy individuals who underwent the physical examination in the hospital during the same period were selected as the control group.The serum levels of sCD54 and presepsin were detected in the two groups.Receiver operating characteristic(ROC)curve was drawn to determine the diagnostic value of sCD54 and presepsin for multiple myeloma,and the factors affecting the prognosis of patients with multiple myeloma were explored by multivariate Logistic regression analysis.Results The serum levels of sCD54 and presepsin in the case group were higher than those in the control group(P<0.05).There were 98 cases with good prognosis and 20 cases with poor prognosis.The serum sCD54 and presepsin levels of patients with good prognosis were lower than those of patients with poor prognosis(P<0.05).Serum sCD54 and presepsin levels were positively correlated with the severity of ISS stage,Ca^(2+) and β_(2) microglobulin(r=0.426-0.723,P<0.05),and were negatively correlated with C-reactive protein(r=-0.572,-0.683,P<0.05).The area under the ROC curve(AUC)of single detection serum sCD54,presepsin and their combined diagnosis of multiple myeloma were 0.784(95%CI:0.713-0.857),0.674(95%CI:0.568-0.763),0.832(95%CI:0.783-0.881).Under the cut off value of 310 ng/mL,the diagnostic sensitivity of sCD54 was 75.5%and the specificity was 81.3%.Under the cut off value of 280 pg/mL,the diagnostic sensitivity of presepsin was 67.2%and the specificity was 68.4%.The sensitivity of combined detection was 80.5%,and the specificity was 91.2%.The results of multivariate Logistic regression analysis showed that the increase of sCD54 and presepsin levels were independent risk factors for po

关 键 词：可溶性CD54 可溶性CD14分子亚型 多发性骨髓瘤 预后 

分 类 号：R446.1[医药卫生—诊断学]