CD24抗原在多发性骨髓瘤患者中的表达和诱导治疗疗效的预测价值  

The expression of CD24 antigen in multiple myeloma patients and its predictive value after induction therapy

作　　者：刘梦茹 褚彬 陈远 王梦真 陆敏秋 高珊 石磊 项秋晴 房立娟 闫麒 纪娜 孙恺 鲍立 Liu Mengru;Chu Bin;Chen Yuan;Wang Mengzhen;Lu Minqiu;Gao Shan;Shi Lei;Xiang Qiuqing;Fang Lijuan;Yan Qi;Ji Na;Sun Kai;Bao Li(Department of hematology,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100096,China)

机构地区：[1]首都医科大学附属北京积水潭医院血液内科,北京100096

出　　处：《中华检验医学杂志》2024年第10期1178-1185,共8页Chinese Journal of Laboratory Medicine

基　　金：北京积水潭医院自然基金培育计划(ZR-202213,ZR-202226)。

摘　　要：目的分析CD24抗原在多发性骨髓瘤(MM)患者骨髓浆细胞(BMPC)上表达情况以及诱导治疗疗效的预测价值。方法观察性研究。本研究标本均来自2022年8月12日至2024年2月1日期间就诊于首都医科大学附属北京积水潭医院血液科258例MM患者。按疾病不同阶段分为新诊断MM(NDMM)共78例[男42例、女36例、年龄(62±11)岁]、复发难治组56例(男34例、女22例、年龄64±9岁)、疾病缓解组124例[男68例、女56例、年龄(62±10)岁]。以多参数流式细胞术(MFC)检测MM患者BMPC上CD24抗原表达水平作为研究对象,分析CD24表达与MM疾病状态的关系。回顾性分析78例NDMM患者初诊时临床资料及实验室结果,包括性别、年龄、MFC检测目的抗原CD24及对照抗原(包括CD19、CD20、CD24、CD27、CD56)的结果、诱导治疗后评效、ISS分期、R-ISS分期、血红蛋白、β2微球蛋白、人血白蛋白,血肌酐、乳酸脱氢酶、校正血钙、BMPC比例、FISH检测结果。以NDMM患者初诊时MFC检测BMPC上CD24及对照抗原阳性率作为研究对象,按照诱导治疗评效不同分为深度缓解组[包括完全缓解(CR)和非常好的部分缓解(VGPR)]共43例,非深度缓解组(非CR和VGPR)共17例,采用单因素分析对比两组患者BMPC上各抗原表达的差异,二元Logistic回归分析患者初诊时抗原表达与诱导治疗后疗效的关系。以NDMM患者初诊时CD24阳性率和诱导治疗后是否达深度缓解作为研究对象,利用受试者工作特征(ROC)曲线分析CD24对NDMM患者诱导治疗后达深度缓解的预测价值,同时得出最佳临界值。依据临界值将NDMM分成两组,比较两组间临床基线资料和预后指标之间的差异。结果NDMM、复发难治组、疾病缓解组的浆细胞CD24阳性率分别是2.18%(95%CI 0.08%~81.85%)、3.81%(95%CI 0.10%~64.56%)、8.74%(95%CI 0.79%~95.55%)。与疾病缓解组相比,NDMM和复发难治组的浆细胞CD24阳性率更低(Z分别为-7.889,-5.282,P均<0.001)。单因素�ObjectiveThis study analyzed the expression of CD24 antigen on bone marrow plasma cells(BMPC)of patients with multiple myeloma(MM)and the predictive value of induction therapy.MethodsThis clinical observational study utilized 258 MM patients samples treated at the Hematology Department of Beijing Jishuitan Hospital who met the inclusion criteria in the Department of Hematology,Capital Medical University,from August 12th,2022 to February 1st,2024.According to the different stages of the disease,patients were divided into three groups:78 cases of Newly Diagnosed Multiple Myeloma(NDMM)(42 males and 36 females,aged 62±11),56 cases of the relapse refractory group(34 males and 22 females,aged 64±9),and 124 cases of the disease remission group(68 males and 56 females,aged 62±10).Multiparameter flow cytometry(MFC)was used to detect the expression level of CD24 antigen on BMPC and the relationship between CD24 and MM disease status.The clinical data and test results of 78 NDMM patients at initial diagnosis were retrospectively analyzed,including gender,age,MFC detection of the positive expression rate of antigens(CD19,CD20,CD24,CD27,CD56),the results of efficacy evaluation after induction therapy,ISS staging,R-ISS staging,blood hemoglobin,β2-microglobulin,human serum albumin,serum creatinine,lactate dehydrogenas,correction of calcium,BMPC ratio,and the results of FISH.The patients were divided into a deep remission group[including complete remission(CR)and very good partial remission(VGPR)]with 43 cases and a non-deep remission group(non CR and VGPR)with 17 cases according to the difference of antigen positive expression rate after induction therapy.The differences of antigen expression on BMPC between the two groups were compared.Binary logistic regression was used to analyze the relationship between the expression of each antigen and the efficacy after induction therapy in patients,and the results showed that CD24 was more correlated with the achievement of deep remission after induction therapy than other antigens.

关 键 词：多发性骨髓瘤 CD24 骨髓浆细胞 

分 类 号：R733.3[医药卫生—肿瘤]