sFLC、血清钙离子在多发性骨髓瘤患者诊断及预后判断中的应用价值  

The Value of sFLC and Serum Calcium in the Diagnosis and Prog-nosis of Multiple Myeloma Patients

作　　者：裴晓杭 张丽娜 周盼 王同保[1] 连成 张萍 雷平冲[1] 朱尊民[1] PEI Xiao-Hang;ZHANG Li-Na;ZHOU Pan;WANG Tong-Bao;LIAN Cheng;ZHANG Ping;LEI Ping-Chong;ZHU Zun-Min(Department of Hematology,Henan Provincial People′s Hospital,Zhengzhou 450003,Henan Province,China;Renal Immune Laboratory,Henan Provincial People′s Hospital,Zhengzhou 450003,Henan Province,China)

机构地区：[1]河南省人民医院血液科,河南郑州450003 [2]河南省人民医院肾脏免疫实验室,河南郑州450003

出　　处：《中国实验血液学杂志》2024年第3期794-798,共5页Journal of Experimental Hematology

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20200049)。

摘　　要：目的:探讨血清游离轻链(sFLC)、血清钙离子在多发性骨髓瘤(MM)患者诊断及预后中的临床应用价值。方法:选取2018年1月至2022年1月在河南省人民医院治疗的MM患者40例作为观察组,同时选取健康志愿者40例作为对照组,比较两组患者的sFLC-κ、sFLC-λ、sFLC-κ/λ、血清钙离子等差异性,同时分析观察组不同国际分期系统(ISS)、不同化疗疗效及不同预后患者的sFLC-κ、sFLC-λ、sFLC-κ/λ、血清钙离子等差异性。结果:观察组sFLC-κ水平[(98.39±21.19)对(12.01±4.45)mg/L]、sFLC-λ水平[(210.20±45.54)对(14.10±5.11)mg/L]、低钙血症比例(65%对0)均明显高于对照组(P<0.05),而sFLC-κ/λ比值[(0.44±0.10)对(0.87±0.12)]、血清钙离子[(1.98±0.46)对(2.42±0.40)mmol/L]明显低于对照组(P<0.05)。观察组ISS分期Ⅲ期患者sFLC-κ、sFLC-λ浓度、低钙血症比例和低钙血症病程均明显高于Ⅰ期和Ⅱ期患者(P<0.05),而sFLC-κ/λ、血清钙离子均明显低于Ⅰ期和Ⅱ期患者(P<0.05)。观察组有低钙血症患者sFLC-κ水平[(107.76±21.22)对(94.67±20.11)mg/L]、sFLC-λ水平[(245.54±41.12)对(205.54±50.22)mg/L]明显高于无低钙血症患者(P<0.05),而sFLC-κ/λ比值明显低于无低钙血症患者[(0.42±0.04)对(0.47±0.06);P<0.05]。化疗无效患者sFLC-κ水平[(107.29±20.14)对(91.11±18.92)mg/L]、sFLC-λ水平[(247.98±42.26)对(179.29±39.32)mg/L]明显高于化疗有效患者(P<0.05),而sFLC-κ/λ比值明显低于化疗有效患者[(0.43±0.10)对(0.50±0.09);P<0.05]。sFLC-κ、sFLC-λ、sFLC-κ/λ预测化疗无效的ROC曲线下面积分别为0.803、0.793和0.699,P<0.05。存活和死亡患者的sFLC-κ、sFLC-λ、sFLC-κ/λ、血清钙离子、低钙血症比例和低钙血症病程比较差异无统计学意义(均P>0.05)。结论:sFLC、血清钙离子与MM患者ISS分期有关,sFLC水平在预测MM患者化疗疗效方面有一定应用价值,sFLC与血清钙离子在判断MM患者预后方面暂未发现有应用价值。Objective:To investigate the value of serum free light chain(sFLC)and serum calcium ion in the diagnosis and prognosis of multiple myeloma(MM).Methods:Forty patients with MM treated in Henan Provincial People′s Hospital from January 2018 to January 2022 were selected as the observation group,and 40 healthy volunteers were selected as the control group.The differences of sFLC-κ,sFLC-λ,sFLC-κ/λ,serum calcium ions,etc between the two groups were compared.Meanwhile,the differences of sFLC-κ,sFLC-λ,sFLC-κ/λ,serum calcium ions,etc in different international staging systems(ISS),chemotherapy efficacy and prognosis patients were analyzed.Results:The levels of sFLC-κ[(98.39±21.19)vs(12.01±4.45)mg/L],sFLC-λ[(210.20±45.54)vs(14.10±5.11)mg/L]and proportions of hypocalcemia(65%vs 0)in the observation group were significantly higher than those in the control group(P<0.05),while sFLC-κ/λratio[(0.44±0.10)vs(0.87±0.12)]and serum calcium ions[(1.98±0.46)vs(2.42±0.40)mmol/L]were significantly lower than those in the control group(P<0.05).The sFLC-κ,sFLC-λ,the proportion of hypocalcemia and the course of hypocalcemia in ISS stage III patients in the observation group were significantly higher than those in stage I and II patients(P<0.05),while sFLC-κ/λratio,and serum calcium ions were significantly lower than those in stage I and II patients(P<0.05).The levels of sFLC-κ[(107.76±21.22)vs(94.67±20.11)mg/L],sFLC-λ[(245.54±41.12)vs(205.54±50.22)mg/L]of patients with hypocalcemia in the observation group was significantly higher than those without hypocalcemia(P<0.05),while the sFLC-κ/λratio was significantly lower than those without hypocalcemia[(0.42±0.04)vs(0.47±0.06);P<0.05].The levels of sFLC-κ[(107.29±20.14)vs(91.11±18.92)mg/L],sFLC-λ[(247.98±42.26)vs(179.29±39.32)mg/L]in patients with ineffective chemotherapy were significantly higher than those in patients with effective chemotherapy(P<0.05),while the sFLC-κ/λratio was significantly lower than those in patients with effective chemothera

关 键 词：血清游离轻链 血清钙离子 多发性骨髓瘤 化疗疗效 预后判断 

分 类 号：R733.3[医药卫生—肿瘤]