多发性骨髓瘤患者首次治疗部分缓解时NLR、MLR与预后的关系  

Relationships between NLR,MLR and prognosis in patients with multiple myeloma in first partial remission

作　　者：王豪言 孙晓白 李梦一 牛俊伟 白炎亮 孙恺 WANG Haoyan;SUN Xiaobai;LI Mengyi;NIU Junwei;BAI Yanliang;SUN Kai(Department of Hematology,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学人民医院河南省人民医院血液科,郑州450003

出　　处：《山东医药》2023年第8期1-5,共5页Shandong Medical Journal

基　　金：国家自然科学基金项目(81971508)。

摘　　要：目的探讨多发性骨髓瘤(MM)患者首次治疗部分缓解时中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)与预后的关系。方法经治疗后首次部分缓解的MM患者106例,随访观察患者生存情况,计算无进展生存期(PFS)和总生存期(OS)。采用受试者工作特征(ROC)曲线分析首次部分缓解时NLR和MLR预测患者预后的效能并获取最佳截断值,将患者分为高NLR组、低NLR组和高MLR组、低MLR组,分别比较高NLR组与低NLR组、高MLR组与低MLR组患者的PFS和OS。收集首次部分缓解时患者的年龄、性别、血红蛋白、白/球蛋白比值、乳酸脱氢酶、β2-微球蛋白、血清钙、胱抑素C、轻链类型、NLR、MLR资料,纳入Cox回归分析模型,分析MM患者PFS、OS的影响因素。结果106例患者随访至2022年10月,死亡27例,总生存率为74.5%。患者中,高NLR组(NLR>2.14)49例、低NLR组(NLR≤2.14)57例和高MLR组(MLR>0.36)46例、低MLR组(MLR≤0.36)60例。低NLR组尿酸<283.5μmol/L者比例高于高NLR组,低MLR组Hb≥96 g/L者比例高于高MLR组(P均<0.05)。高NLR组中位PFS和中位OS低于低NLR组,高MLR组中位OS低于低MLR组(P均<0.05)。首次部分缓解时NLR是MM患者PFS的独立影响因素,白球比和NLR是OS的独立影响因素(P均<0.05)。结论MM患者首次治疗部分缓解时的NLR、MLR与预后有关,其中NLR是预后的独立影响因素,NLR升高提示预后不良,NLR可作为MM诱导治疗中间阶段评估预后的指标。Objective To investigate the relationships between neutrophil-to-lymphocyte ratio(NLR),monocyte-tolymphocyte ratio(MLR)and prognosis in patients with multiple myeloma(MM)in first partial remission.Methods One hundred and six patients with MM in first partial remission after treatment were followed up to observe their survival and to calculate progression-free survival(PFS)and overall survival(OS).The efficacy of NLR and MLR in predicting pa⁃tient prognosis in partial remission was analyzed using receiver operating characteristic(ROC)curves,and the best cut-off values were obtained.Patients were then divided into the high NLR group,low NLR group,and high MLR group and low MLR group;PFS and OS were compared between patients in the high NLR group and low NLR group and between patients in the high MLR group and low MLR group,respectively.Patients'age,gender,haemoglobin,albumin/globulin ratio,lactate dehydrogenase,β2-microglobulin,serum calcium,cystatin C,light chain type,NLR,MLR information were in⁃cluded in the Cox regression analysis model to analyse the factors influencing PFS and OS in MM patients.Results The 106 patients were followed up until October 2022,with 27 deaths and an overall survival rate of 74.5%.The patients were divided into the high NLR group(NLR>2.14)of 49 patients,the low NLR group(NLR≤2.14)of 57 patients and the high MLR group(MLR>0.36)of 46 patients,and the low MLR group(MLR≤0.36)of 60 patients.The proportion of uric acid<283.5 mmol/L was higher in the low NLR group than in the high NLR group(P<0.05);the proportion of Hb≥96 g/L was higher in the low MLR group than in the high MLR group(P<0.05).Median PFS and median OS were lower in the high NLR group than in the low NLR group,and median OS was lower in the high MLR group than in the low MLR group(both P<0.05).Multi-factor Cox regression analysis showed that NLR in first partial remission was an independent influencing factor for PFS and white sphere ratio and NLR were independent influencing factors for OS in MM patients(all P<0.05)

关 键 词：多发性骨髓瘤 部分缓解 中性粒细胞/淋巴细胞比值 单核细胞/淋巴细胞比值 

分 类 号：R733.3[医药卫生—肿瘤]