骨髓CKS1B、p53基因表达对多发性骨髓瘤患者化疗效果及预后的评估价值  

Evaluation of CKS1B and p53 gene expression in bone marrow for chemotherapy effect and prognosis in patients with multiple myeloma

作　　者：廖彩翔[1] 黎国伟[1] 秦晓铧[1] LIAO Caixiang;LI Guowei;QIN Xiaohua(Department of Hematology,Huizhou Central People's Hospital,Huizhou,Guangdong,China,516000)

机构地区：[1]惠州市中心人民医院血液内科,广东惠州516000

出　　处：《分子诊断与治疗杂志》2022年第10期1722-1726,共5页Journal of Molecular Diagnostics and Therapy

基　　金：惠州市科技计划项目(2021WC0106356)。

摘　　要：目的 探讨骨髓CKS1B、p53基因表达对多发性骨髓瘤(MM)患者化疗效果及预后的评估价值研究。方法 选取2020年6月至2022年3月收治于惠州市中心人民医院的86例MM患者作为研究对象。所有患者化疗4个疗程(硼替佐米+地塞米松+来那度胺,28d为1个疗程)后根据2014国际骨髓瘤工作组标准将86例MM患者分为有效组(n=53)和无效组(n=33),绘制ROC曲线评估其在MM患者疗效监测中的价值。根据骨髓CKSIB、p53基因水平阳性表达分组,比较患者临床特点并采用Cox回归模型分析MM患者生存状况。结果 有效组MM患者骨髓CKS1B、p53阳性表达率显著低于无效组,差异有统计学意义(χ^(2)=3.853,14.682,P均<0.001)。绘制CKS1B、p53对MM患者疗效监测的ROC曲线分析显示,CKS1B、p53的最佳截断值分别为0.78、0.51,AUC分别为0.851、0.896,敏感度为75.75%、90.90%,特异度为77.35%、83.01%。MM患者的骨髓CKS1B、p53阳性表达与R-ISS分期、C反应蛋白、血红蛋白有关,差异有统计学意义(χ^(2)=5.045,7.232,4.282,P均<0.05)。Cox多因素回归分析结果显示,白细胞、血红蛋白、CKS1B及p53为MM患者预后不良的独立影响因素(P<0.05)。结论 骨髓CKSIB、p53对MM患者疗效监测有一定价值,MM中骨髓CKSIB、p53阳性表达与白细胞、血红蛋白及预后密切相关。Objective To investigate the value of bone marrow CKS1B and p53 gene expression in evaluating the effect of chemotherapy and prognosis in patients with multiple myeloma(MM). Methods A total of 86 MM patients admitted to Huizhou Central People’s Hospital from June 2020 to March 2022 were selected as the research subjects. All patients received 4 courses of chemotherapy(bortezomib +dexamethasone + lenalidomide,28 days as a course). According to the 2014 International Myeloma Working Group criteria,86 patients with MM were divided into an effective group(n=53)and an ineffective group(n=33). The ROC curve was drawn to evaluate its value in monitoring the curative effect of MM patients.According to the positive expression levels of CKSIB and p53 genes in bone marrow,the patients were divided into groups,the clinical characteristics of the patients were compared,and the Cox regression model was used to analyze the survival status of MM patients. Results The positive expression rates of CKS1B and p53 in the bone marrow of MM patients in the effective group were significantly lower than those in the ineffective group,and the difference was statistically significant(χ^(2)=3.853,14.682,P<0.001). The ROC curve analysis of the efficacy monitoring of CKS1B and p53 in MM patients showed that the best cut-off values of CKS1B and p53 were 0.78 and 0.51,respectively,the AUC was 0.851 and 0.896,the sensitivity was 75.75%,90.90%,and the specificity was 77.35%,83.01%. The positive expression of CKS1B and p53 in the bone marrow of MM patients was related to R-ISS stage,C-reactive protein,and hemoglobin,and the difference was statistically significant(χ^(2)=5.045,7.232,4.282,P<0.05). Cox multivariate regression analysis showed that white blood cells,hemoglobin,CKS1B and p53 were independent influencing factors of poor prognosis in MM patients(P<0.05). Conclusion Bone marrow CKSIB and p53 have certain value in monitoring the curative effect of MM patients. The positive expression of bone marrow CKSIB and p53 in MM is closely relate

关 键 词：多发性骨髓瘤 CKSIB p53 疗效监测 预后 

分 类 号：R733.3[医药卫生—肿瘤]