多发性骨髓瘤中p53基因表达与R-ISS分期及预后的相关性分析  

Correlation between p53 gene and R-ISS stage in multiple myeloma

作　　者：姚悦 冯玉虎[1] 张苗[1] 武晓倩 李雪 尚留 王秀秀 YAO Yue;FENG Yu-hu;ZHANG Miao(Department of Hematology,Fuyang People's Hospital,Fuyang Anhui 236000,China)

机构地区：[1]阜阳市人民医院血液内科,安徽阜阳236000

出　　处：《临床和实验医学杂志》2023年第14期1486-1489,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽省自然科学基金(编号:1808085MH236)。

摘　　要：目的 研究多发性骨髓瘤患者p53基因表达情况与修订的国际分期系统(R-ISS)及预后的相关性。方法 回顾性纳入2018年10月至2021年12月阜阳市人民医院收治的86例多发性骨髓瘤患者为研究对象。采用荧光原位杂交技术检测患者p53基因表达情况,并收集所有患者临床一般资料,包括性别、年龄、体重指数、免疫球蛋白类型及R-ISS分期,分析多发性骨髓瘤患者p53基因表达情况及其与临床特征的关系。所有患者均接受标准化疗方案治疗,评估治疗疗效,并分析p53基因表达情况与临床疗效的关系。所有患者均接受1年随访,观察患者生存情况,比较p53基因阳性及缺失组与p53基因阴性组患者1年存活率。结果 86例多发性骨髓瘤患者中,p53基因阳性及缺失组患者7例,占8.14%,p53基因阴性组患者79例,占91.86%。p53基因阳性及缺失组和p53基因阴性组患者性别构成比、年龄、体重指数、免疫球蛋白类型比较,差异均无统计学意义(P>0.05);p53基因阳性及缺失组患者中R-ISS分期为Ⅲ期的患者占比为71.43%,显著高于p53基因阴性组(21.52%),差异有统计学意义(P<0.05)。经标准化疗方案治疗后,86例多发性骨髓瘤患者中,完全缓解13例,部分缓解38例,疾病稳定24例,疾病进展11例。有效组患者共51例,无效组患者共35例。无效组患者中p53基因阳性及缺失患者占比高于有效组患者,但差异无统计学意义(P>0.05)。入组患者均获得有效随访,p53基因阳性及缺失组患者1年累计生存率为71.43%(5/7);p53基因阴性组患者1年累计生存率为84.81%(67/79)。两组患者1年累计生存率比较,差异无统计学意义(P>0.05)。结论 p53基因表达情况影响多发性骨髓瘤的发生、发展,并与R-ISS分期密切相关,伴有p53基因阳性及缺失的患者的化疗疗效及预后可能较差,临床需对多发性骨髓瘤细胞中p53基因异常的患者进一步探寻新型治疗方法,延长患者生存期。Objective To investigate the correlation between p53 gene expression and the modified International Staging System(R-ISS)and prognosis in patients with multiple myeloma.Methods The retrospective analysis was used and 86 patients with multiple myeloma admitted to Fuyang People's Hospital from October 2018 to December 2021 were included as subjects.Fluorescence in situ hybridization was used to detect the expression of p53 gene in patients with multiple myeloma.General clinical data of all patients,including gender,age,body mass index,immunoglobulin type and R-ISS staging were collected to analyze the expression of p53 in patients with multiple myeloma and its relationship with clinical characteristics.All patients were treated with standard chemotherapy regimen.Therapeutic efficacy was evaluated and the relationship between p53gene expression and therapeutic efficacy was analyzed.All patients were followed up for 1 year to observe the survival of patients,and the 1-year survival rate of patients in positive and deletion p53 gene groups and p53 gene negative group was compared.Results Among 86 patients with multiple myeloma,7 cases were in the p53 gene positive and deletion group(8.14%),and 79 cases were in the p53 gene negative group(91.86%).There were no statistically significant differences in gender,age,body mass index and immunoglobulin type between p53 gene positive and deletion groups and p53 gene negative groups(P>0.05).The proportion of patients with R-ISS stageⅢin p53 gene positive and deletion groups was 71.43%,which was significantly higher than that in p53 gene negative group(21.52%),the difference was statistically significant(P<0.05).After standard chemotherapy regimen treatment,out of 86 patients with multiple myeloma,13 had complete remission,38 had partial remission,24 had stable disease,and 11 had disease progression.There were a total of 51 patients in the effective group and 35 patients in the ineffective group.The proportion of p53 gene positive and missing patients in the ineffective group

关 键 词：多发性骨髓瘤 P53基因 R-ISS分期 预后 疗效 存活率 

分 类 号：R733.3[医药卫生—肿瘤]