血小板与淋巴细胞比值在多发性骨髓瘤预后中的价值  

Prognostic Value of Platelet to Lymphocyte Ratio in Multiple Myeloma

作　　者：王晓雪 王芝涛 秦慧[1,2] WANG Xiao-xue;WANG Zhi-tao;QIN Hui(Department of Hematology,the Second Hospital of Anhui Medical University,Hefei 230601,Anhui,China;Hematology Research Center of Anhui Medical University,Hefei 230032,Anhui,China)

机构地区：[1]安徽医科大学第二附属医院血液内科,安徽合肥230601 [2]安徽医科大学血液病研究中心,安徽合肥230032

出　　处：《医学信息》2022年第12期109-112,共4页Journal of Medical Information

基　　金：安徽省自然科学基金项目(编号:2008085QH372)。

摘　　要：目的 分析外周血血小板计数与淋巴细胞比值(PLR)在多发性骨髓瘤患者预后中的价值。方法 收集2015年1月-2019年9月安徽医科大学第二附属医院收治的138例初诊多发性骨髓瘤患者的临床资料,依据受试者工作特征(ROC)曲线确定PLR的最佳截断值并将患者分为高PLR组和低PLR组,比较两组一般资料及实验室指标,并分析PLR在预后中的价值。结果 ROC曲线分析显示,RLR预测多发性骨髓瘤生存最佳截断值为133.88,其中AUC为0.600,灵敏度46.60%,特异度76.60%。高PLR组和低PLR组分型、有无髓外疾病比较,差异有统计学意义(P<0.05)。138例多发性骨髓瘤患者共58例死亡,死亡率为42.03%;高PLR组中位OS为29个月(1~71个月),低PLR组中位OS为27个月(1~79个月),组间比较,差异有统计学意义(P<0.05);单因素Cox分析显示,EOCG评分、血小板计数、PLR水平、乳酸脱氢酶、髓外病变与多发性骨髓瘤患者OS有关;多因素Cox分析显示,血小板计数<100×109/L、PLR≥133.88、乳酸脱氢酶≥250 U/L、髓外病变是影响多发性骨髓瘤患者OS的独立不良预后因素。结论 初诊时外周血PLR与多发性骨髓瘤髓外病变相关,对预后具有一定的预测价值,是多发性骨髓瘤患者OS的独立预后预测指标。Objective To analyze the prognostic value of peripheral blood platelet to lymphocyte ratio(PLR) in patients with multiple myeloma.Methods The clinical data of 138 patients with newly diagnosed multiple myeloma admitted to the Second Affiliated Hospital of Anhui Medical University from January 2015 to September 2019 were collected.The optimal cut-off value of PLR was determined according to the receiver operating characteristic(ROC) curve and the patients were divided into high PLR group and low PLR group.The general data and laboratory indexes were compared between the two groups,and the value of PLR in prognosis was analyzed.Results ROC curve analysis showed that the optimal cutoff value of RLR for predicting the survival of multiple myeloma was 133.88,with AUC of 0.600,the sensitivity was 46.60% and specificity was 76.60%.There was a statistically significant difference between the high PLR group and the low PLR group in component types and the presence of extramyelopathy(P<0.05).There were 58 deaths in 138 patients with multiple myeloma,with a mortality rate of 42.03%;the median OS in the high PLR group was 29months(1-71 months),and that in the low PLR group was 27 months(1-79 months),the difference between groups was statistically significant( P<0.05).Univariate Cox analysis showed that EOCG score,platelet count,PLR level,lactate dehydrogenase and extramedullary lesions were associated with OS in patients with multiple myeloma.Multivariate Cox analysis showed that platelet count <100 ×109/L,PLR≥133.88,lactate dehydrogenase≥250 U/L and extramedullary lesions were independent poor prognostic factors for OS in patients with multiple myeloma.Conclusion PLR in peripheral blood at initial diagnosis is associated with extramedullary lesions in multiple myeloma,which has certain predicative value for prognosis and is an independent prognostic predictor of OS in patients with multiple myeloma.

关 键 词：多发性骨髓瘤 血小板与淋巴细胞比值 总体生存期 

分 类 号：R733.3[医药卫生—肿瘤]