血清P1NP、β-CTX水平联合骨髓细胞形态学检查对多发性骨髓瘤的诊断价值  

Diagnostic value of serum P1NP andβ-CTX levels combined with bone marrow cells morphological examination for multiple myeloma

作　　者：康成[1] 张文[1] 张璐[1] 马小妮 蒲三多 KANG Cheng;ZHANG Wen;ZHANG Lu;MA Xiaoni;PU Sanduo(Medical Laboratory Center,the First Hospital of Lanzhou University,Lanzhou,Gansu 730000,China)

机构地区：[1]兰州大学第一医院医学检验中心,甘肃兰州730000

出　　处：《国际检验医学杂志》2024年第8期936-939,945,共5页International Journal of Laboratory Medicine

基　　金：甘肃省科技计划项目(21JR11RA078)。

摘　　要：目的 探讨骨髓细胞形态学检查联合血清Ⅰ型前胶原氨基端前肽(P1NP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)检测对多发性骨髓瘤(MM)及其分期的诊断价值。方法 选取2020年1月至2023年2月在该院就诊的104例MM患者作为研究对象,根据国际分期标准(ISS)分为Ⅰ期、Ⅱ期和Ⅲ期,分别为32例、36例和36例。同时选取同期因为缺铁性贫血、再生障碍性贫血、骨髓增生异常综合征等原因接受骨髓穿刺的40例作为对照组。对所有受试者进行骨髓细胞形态学检查,测定血清P1NP和β-CTX水平,并分析其与MM及其分期的关系。结果 MM组骨髓浆细胞比[(23.4±8.6)%]、血清P1NP[(120.5±35.6)ng/mL]和β-CTX水平[(820.4±210.3)pg/mL]均显著高于对照组[(3.2±1.4)%、(52.3±12.4)ng/mL、(320.6±80.2)pg/mL],差异均有统计学意义(P<0.05),且随着MM分期的升高而增高。以骨髓浆细胞比例≥10%、血清P1NP≥80 ng/mL和β-CTX≥500 pg/mL为诊断标准,对MM的灵敏度和特异度分别为92.3%和95.0%,联合检测的灵敏度和特异度分别为98.1%和100.0%。以血清P1NP≥100 ng/mL和β-CTX≥700 pg/mL为分期标准,对MMⅢ期的灵敏度和特异度分别为86.1%和88.2%,联合检测的灵敏度和特异度分别为94.4%和97.1%。结论 骨髓细胞形态学检查联合血清P1NP、β-CTX检测对MM及其分期具有较高的诊断价值,有助于评估MM患者的病情和预后。Objective To explore the diagnostic value of bone marrow cell morphological examination combined with serum procollagen typeⅠN-terminal propeptide(P1NP)and beta C-terminal cross-linked telopeptides of typeⅠcollagen(β-CTX)detection for multiple myeloma(MM)and its stages.Methods A total of 104 MM patients admitted to this hospital from January 1,2020 to February 1,2023 were selected as the study subjects,and they were divided into stageⅠ,ⅡandⅢaccording to the international staging criteria(ISS),with 32,36 and 36 cases respectively.At the same time,40 patients who underwent bone marrow puncture due to iron deficiency anemia,aplastic anemia,myelodysplastic syndrome and other reasons during the same period were selected as the control group.Bone marrow cell morphological examination was performed in all subjects,serum P1NP andβ-CTX levels were determined,and their relationship with MM and its staging was analyzed.Results The bone marrow plasma cell ratio[(23.4±8.6)%],serum P1NP[(120.5±35.6)ng/mL]andβ-CTX levels[(820.4±210.3)pg/mL]in MM group were significantly higher than those in control group[(3.2±1.4)%,(52.3±12.4)ng/mL,(320.6±80.2)pg/mL],the differences were statistically significant(P<0.05),and increased with the increase of MM stage.With bone marrow plasma cell ratio≥10%,serum P1NP≥80 ng/mL andβ-CTX≥500 pg/mL as diagnostic criteria,the sensitivity and specificity for MM were 92.3%and 95.0%,respectively,and the sensitivity and specificity for combined detection were 98.1%and 100.0%,respectively.Taking serum P1NP≥100 ng/mL andβ-CTX≥700 pg/mL as staging criteria,the sensitivity and specificity for stageⅢMM were 86.1%and 88.2%,respectively,and the sensitivity and specificity for combined detection were 94.4%and 97.1%,respectively.Conclusion Bone marrow cell morphological examination combined with serum P1NP andβ-CTX detection has high diagnostic value for MM and its stage,which is helpful to evaluate the condition and prognosis of MM patients.

关 键 词：多发性骨髓瘤 骨髓细胞形态学 Ⅰ型前胶原氨基端前肽 Ⅰ型胶原羧基端肽β特殊序列 

分 类 号：R733.3[医药卫生—肿瘤] R446.11[医药卫生—临床医学]