晚期肺癌炎症指数在多发性骨髓瘤患者免疫表型及预后中的意义  

Significance of advanced lung cancer inflammatory index in immunophenotype and prognosis of patients with multiple myeloma

作　　者：王志银[1] 宋琛 戴许阳 汤友静 于朦菲 WANG Zhi-yin;SONG Chen;DAI Xu-yang;TANG You-jing;YU Meng-fei(Laboratory of Hematology,the First Affiliated Hospital of Xinxiang Medical University,Weihui,Henan 453100,China)

机构地区：[1]新乡医学院第一附属医院血液学实验室,河南卫辉453100

出　　处：《医药论坛杂志》2024年第18期1911-1916,共6页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230524)。

摘　　要：目的探讨多发性骨髓瘤(multiple myeloma,MM)患者晚期肺癌炎症指数(advanced lung cancer inflammation index,ALI)与免疫表型的相关性及其在患者预后中的临床意义。方法回顾性分析2020年8月至2023年8月在新乡医学院第一附属医院就诊的MM患者126例,统计其流式检测结果中的CD56、CD117、CD200免疫表型,并根据其临床资料和相关生化检验结果计算其ALI指标。根据患者化疗结果将其分为缓解组和未缓解组,比较两组ALI差异并进行受试者工作特征(receiver operating characteristic,ROC)曲线分析获取API最佳截断值,而后将患者分为高ALI组(n=56)和低ALI组(n=70),比较不同组间临床特征参数和免疫表型、生存期差异,Cox回归分析ALI是否为MM患者无进展生存期(progression-free survival,PFS)和总生存期(overall survival,OS)的影响因素。结果缓解组ALI显著高于未缓解组(t=3.766,P<0.001);ALI最佳截断值为36.5。ALI较低组(≤36.5)患者髓外受累比例、ISS分期Ⅲ期比例、β2-微球蛋白、LDH及浆细胞比例显著高于ALI较高组(P<0.05);低ALI组的CD56阳性比例显著低于高ALI组(P<0.05),其他免疫表型组间无显著差异(P>0.05);低ALI组的PFS及OS均显著低于高ALI组(分别χ^(2)=9.668,P<0.001;χ^(2)=12.689,P<0.001),较高ALI是PFS及OS的独立保护因素(P<0.05)。结论MM患者ALI与其髓外受累等临床特征和CD56免疫表型密切相关,且高ALI是患者预后生存期的独立保护因素。Objective To explore the correlation between advanced lung cancer inflammatory index(ALI)and immunophenotype of patients with multiple myeloma(MM)and its clinical significance in patient prognosis.Methods Totally 126 MM patients treated in the First Affiliated Hospital of Xinxiang Medical University from August 2020 to August 2023 were retrospectively analyzed.Their immunophenotypes of CD56,CD117 and CD200 were analyzed,and their ALI were calculated according to the clinical data and related biochemical test results.Patients were divided into remission group and non-remission group according to chemotherapy results.ALI differences between the two groups were compared and receiver operating characteristic(ROC)curve analysis was performed to obtain the cut-off value of ALI.The patients were divided into the high ALI group(n=56)and low ALI group(n=70),and differences in clinical characteristics,immunophenotype and survival between different groups were compared.Cox regression analysis was performed to determine whether ALI was an influential factor in progression-free survival(PFS)and overall survival(OS)of MM patients.Results ALI in the remission group was significantly higher than that in non-remission group(t=3.766,P<0.001);the optimal ALI cut-off value was 36.5.The proportion of patients with extramedullary involvement,III ISS stage,β2-microglobulin,LDH and abnormal plasma cell ratio in low ALI group were significantly higher than those in high ALI group(all P<0.05);the proportion of CD56 positive in the low ALI group was significantly lower than that in the high ALI group(P<0.05),no significant difference was found between other immunophenotypic groups(P>0.05);both the PFS and OS of the low ALI group were significantly lower than those of the high ALI group(χ^(2)=9.668,P<0.001;χ^(2)=12.689,P<0.001),and higher ALI was an independent protective factor for PFS and OS(P<0.05).Conclusion ALI in MM patients is closely related to clinical features such as extramedullary involvement and CD56 immunophenotype,and high

关 键 词：多发性骨髓瘤 晚期肺癌炎症指数 中性粒细胞与淋巴细胞比值 免疫表型 预后 

分 类 号：R733.3[医药卫生—肿瘤]