多发性骨髓瘤手术治疗患者外周血细胞积分和IL-32与预后的关系  

Relation between peripheral blood cell score combined with IL-32 and prognosis of patients undergoing surgical treatment for multiple myeloma

作　　者：马丽媛[1] 于小汇[1] 张宁宇[1] MA Liyuan;YU Xiaohui;ZHANG Ningyu(Department of Clinical Laboratory,Dalian Second People's Hospital,Dalian 116000,Liaoning,China)

机构地区：[1]大连市第二人民医院检验科,辽宁大连116000

出　　处：《检验医学》2024年第5期458-463,共6页Laboratory Medicine

摘　　要：目的探讨多发性骨髓瘤(MM)手术治疗患者外周血细胞积分和白细胞介素(IL)-32水平与预后的关系。方法选取2019年1月—2021年1月大连市第二人民医院行手术治疗的MM患者102例。检测所有患者术前1 d的单核细胞绝对数(MO#)、血小板(PLT)计数、红细胞平均体积(MCV)和IL-32水平,计算外周血细胞积分。收集所有患者的临床资料和实验室检测结果。对患者进行术后随访(1年),根据MM患者的生存情况分为存活组(76例)和死亡组(26例)。采用受试者工作特征(ROC)曲线分析各项指标判断MM患者术后死亡的效能。采用Kaplan-Meier生存曲线分析MM患者的预后情况,采用Cox比例风险回归分析评估MM患者术后死亡的危险因素。结果死亡组外周血细胞积分2~3分、MO#>0.6×10^(9)·L^(-1)和MCV>100 fL所占比例,以及胱抑素C(Cys C)、IL-32水平均高于存活组(P<0.05)。ROC曲线分析结果显示,外周血细胞积分、IL-32单项检测和联合检测(串联)判断MM患者术后死亡的曲线下面积(AUC)分别为0.811、0.837、0.905。Kaplan-Meier生存曲线分析结果显示,外周血细胞积分2~3分组生存率显著低于0~1分组(P<0.05),高IL-32组(IL-32≥62.38 ng·L^(-1))生存率显著低于低IL-32组(IL-32<62.38 ng·L^(-1))(P<0.05)。Cox比例风险回归分析结果显示,外周血细胞积分、IL-32和Cys C均是MM患者术后1年死亡的危险因素[风险比(HR)分别为3.854、3.677、3.575,95%可信区间(CI)分别为1.394~10.650、1.330~10.161、1.294~9.880]。结论外周血细胞积分联合IL-32可作为判断MM患者术后1年死亡的敏感指标。Objective To investigate the relation between peripheral blood cell score combined with interleukin(IL)-32 level and the prognosis of patients with multiple myeloma(MM)after surgical treatment.Methods A total of 102 MM patients who underwent surgical treatment in Dalian Second People's Hospital from January 2019 to January 2021 were enrolled.The absolute value of monocytes(MO#),platelet(PLT)count,mean corpuscular volume(MCV)and IL-32 level were determined at 1 d before operation,and the peripheral blood cell score was calculated.The clinical data and laboratory determination results of all the patients were collected.After 1 year of follow-up,MM patients were classified into survival group(76 cases)and death group(26 cases).Receiver operating characteristic(ROC)curve was used to analyze the efficacy of each index in predicting postoperative mortality of MM patients.Kaplan-Meier survival curve was used to analyze the prognosis of MM patients,and Cox proportional hazard regression analysis was used to evaluate the risk factors for postoperative death of MM patients.Results The death group had higher percentages of peripheral blood cell score 2-3,MO#>0.6×10^(9)·L^(-1),MCV>100 fL,cystatin C(Cys C)and IL-32 levels than survival group(P<0.05).The areas under curves(AUC)of peripheral blood cell score and IL-32 single and combined determinations for predicting postoperative death of MM patients were 0.811,0.837 and 0.905,respectively.The survival rate of peripheral blood cell score 2-3 group was lower than that of 0-1 group(P<0.05),and the survival rate of high IL-32 group(IL-32≥62.38 ng·L-1)was lower than that of low IL-32 group(IL-32<62.38 ng·L^(-1))(P<0.05).Peripheral blood cell score,IL-32 and Cys C were all risk factors for death of MM patients at 1 year after operation[hazard ratios(HR)were 3.854,3.677 and 3.575,95% confidence intervals(CI)were 1.394-10.650,1.330-10.161 and 1.294-9.880,respectively].Conclusions Peripheral blood cell score combined with IL-32 can be used as a sensitive index to predict the dea

关 键 词：外周血细胞积分 白细胞介素-32 多发性骨髓瘤 预后 

分 类 号：R446.1[医药卫生—诊断学]