基于硼替佐米治疗反应及BTK表达水平建立非初治多发性骨髓瘤临床预测模型  

A Prognostic Nomogram Based on Response to Bortezomib and BTK Expression for Treatment-Experienced Multiple Myeloma Patients

作　　者：陈慧玲[1] 马成成 柴晔[1] 曾鹏云[1] 吴重阳[1] 岳玲玲[1] 韩悌云 张德奎[2] CHEN Hui-Ling;MA Cheng-Cheng;CHAI Ye;ZENG Peng-Yun;WU Chong-Yang;YUE Ling-Ling;HAN Ti-Yun;ZHANG De-Kui(Department of Hematology,Lanzhou University Second Hospital,Lanzhou 730030,Gansu Province,China;Department of Gastroenterology,Lanzhou University Second Hospital,Lanzhou 730030,Gansu Province,China)

机构地区：[1]兰州大学第二医院血液科,甘肃兰州730030 [2]兰州大学第二医院消化科,甘肃兰州730030

出　　处：《中国实验血液学杂志》2022年第4期1139-1143,共5页Journal of Experimental Hematology

基　　金：兰州大学第二医院“萃英科技创新”计划(CY2018-BJ13,CY2017-MS13)。

摘　　要：目的:基于硼替佐米治疗反应及骨髓瘤细胞BTK表达水平建立非初治多发性骨髓瘤(MM)临床预测模型的列线图(nomogram)。方法:运用Oncomine数据库搜索BTK基因表达水平、性别、年龄、白蛋白水平、Mayo评分、硼替佐米治疗反应、随访时间及生存状态等信息,计算影响MM临床预后的BTK表达水平截断值(cut-off值),对上述因素进行Cox多因素回归分析,并根据独立预后因素制作列线图,用一致性指数(C-index)和校正曲线确定列线图的预测精度和判别能力。结果:多因素分析结果显示,影响患者预后的因素有硼替佐米治疗反应、BTK表达水平及性别,根据上述指标制作的列线图一致性指数为0.729(95%CI,0.642-0.8164),患者1年及2年的生存率的校正曲线与实际观测结果吻合较好。结论:基于BTK表达水平及硼替佐米治疗反应的列线图能准确地预测MM患者的预后。Objective:To establish a prognostic nomogram based on response to bortezomib and BTK expression for treatment-experienced multiple myeloma patients.Methods:The Oncomine database was utilized to determine BTK expression,sex,age,albumin,Mayo index,response to bortezomib treatment,follow-up time and survival status in multiple myeloma(MM)patients.Cut-off point for BTK expression was calculated using R software.Univariate and multivariate analyses by Cox proportional hazards regression were then performed.Significant prognostic factors were combined to build a nomogram.The discrimination ability and predictive accuracy of the nomogram were evaluated using the index of concordance(C-index)and calibration curves.Results:Multivariate analysis showed that response to bortezomib,BTK expression and sex were independent risk factors for prognosis.The C-index value of the nomogram made according to the independent risk factors was 0.729(95%CI,0.642-0.8164).The calibration curves showed good consistency between predicted and actual survivals for 1-year and 2-year overall survival.Conclusion:The proposed nomogram is accurate in predicting the prognosis of patients with MM.

关 键 词：BTK 多发性骨髓瘤 列线图 临床预测模型 Oncomine数据库 

分 类 号：R733.3[医药卫生—肿瘤]