多发性骨髓瘤患者sFLC水平与血液常规指标的相关性研究  

Correlation between Serum Free Light Chain and Blood Routine Parameters in Patients with Multiple Myeloma

作　　者：李丹[1] 江楠 王加强 王智斌 贺元 张娟 LI Dan;JIANG Nan;WANG Jia-Qiang;WANG Zhi-Bin;HE Yuan;ZHANG Juan(School of Laboratory Medicine,Chengdu Medical College,Chengdu 610500,Sichuan Province,China;Depariment of Laboratory Medicine,Sichuan Provincial People's Hospital,University of Electronic Science and Technology of China,Chengdu 610072,Sichuan Province,China)

机构地区：[1]成都医学院检验医学院,四川成都610500 [2]电子科技大学附属医院·四川省人民医院临床医学检验中心,四川成都610072

出　　处：《中国实验血液学杂志》2022年第5期1446-1452,共7页Journal of Experimental Hematology

基　　金：国家自然科学基金青年基金(81802075/H2003);四川省卫生健康委员会基金(编号19PJ118)。

摘　　要：目的:探讨多发性骨髓瘤(MM)患者血清游离轻链(sFLC)水平与血液常规指标的相关性。方法:选择2019年4月至2021年7月在四川省人民院确诊的MM患者347例,分别对sFLC与血清总轻链(sTLC)、外周血常规、凝血及生化参数进行回顾性分析。sFLC与血液常规指标相关性分析计算Pearson或Spearman相关系数;多元逐步线性回归筛选与sFLC相关的联合血液常规指标;评估筛选出的血液常规指标反映sFLC水平的效能,采用独立样本Kruskal-Wallis检验进行组间比较,同时绘制受试者工作特征(ROC)曲线。结果:MM患者中,sFLC与sTLCκ、sTLCλ、sTLCκ/λ、Cr、Urea、Cr、Cys_C呈显著正相关,与eGFR呈显著负相关(|r|≥0.3)。多元线性逐步回归分析结果显示,sFLCκ的影响因素是Cr与sTLCκ(P=0.000, P=0.003);sFLCλ的影响因素是eGFR及sTLCλ(P=0.000, P=0.000);sFLCκ/λ的影响因素是sTLCκ/λ(P=0.032)。独立样本Kruskal-Wallis检验表明,Cr和sTLCκ,eGFR和sTLCλ,TLCκ/λ是反映MM患者sFLCκ、sFLCλ、sFLCκ/λ的良好或较好指标(P<0.05)。ROC曲线分析结果显示,Cr、sTLCκ、eGFR、sTLCλ和TLCκ/λ具有判断MM患者sFLC异常的效能(AUC=0.684-0.875, P<0.05)。结论:sTLCκ、sTLCλ联合肾功指标可以评估MM患者的sFLCκ、sFLCλ水平,而sFLCκ/λ可以由MM患者的sTLCκ/λ评估。Objective:To investigate the correlation between serum free light chain(sFLC)and blood routine parameters in patients with multiple myeloma(MM). Methods: 347patients with multiple myeloma diagnosed in Sichuan people′ s Hospital from April2019to July2021were selected. sFLC,serum total light chain(sTLC),peripheral blood routine,coagulation and biochemical parameters were analyzed retrospectively. The correlation analysis between sFLC and blood routine parameters were calculated by Pearson or Spearman correlation coefficients. Multiple stepwise linear regression was used to screen the combined blood routine parameters related to sFLC. The efficacy of the selected blood routine parameters eflecting sFLC level was evaluated,the Kruskal Wallis test of independent samples was used for inter group comparison,and the receiver operating characteristic(ROC)curve was drawn at the same time.Results:In MM patients,sFLC was positively related with sTLCκ,sTLCλ,sTLCκ/λ,Cr,Urea,Cr and Cys_C significantly,while negatively correlated with eGFR markedly( |r| ≥0.3). Multivariate stepwise linear regression showed that the influence factors of sFLCκwere Cr and sTLCκ (P= 0.000,P= 0.003),the influence factors of sFLCλwere eGFR and sTLCλ(P= 0.000,P= 0.000),the sFLCκ/λinfluence factor was sTLCκ/λ (P= 0.032). Kruskal Wallis test of independent samples showed that Cr and sTLCκ,eGFR and sTLCλ,TLCκ/λwere good or better parameters to reflect the level of sFLCκ,sFLCλand sFLCκ/λin MM patients(P< 0.05),respectively. ROC curve analysis shows that Cr,sTLCκ,eGFR,sTLCλand sTLCκ/λhad the ability to judge the abnormality of sFLC in MM patients(AUC= 0.684-0.875,P< 0.05). Conclusion:In MM patients,sTLCκand sTLCλwith renal function parameters could evaluate sFLCκor sFLCλlevel respectively,while sFLCκ/λwas estimated by sTLCκ/λ.

关 键 词：多发性骨髓瘤 血清游离轻链 血液常规指标 

分 类 号：R733.3[医药卫生—肿瘤]