血清sIL-2R联合TNF-α、IgG、IgA对多发性骨髓瘤患者复发的预测价值  

The Predictive Value of Serum sIL-2R Combined with TNF-α, IgG and IgA in the Recurrence of Multiple Myeloma

作　　者：林萍[1] 张雅兰[1] 谢若腾[1] 张学亚[2] LIN Ping;ZHANG Ya-Lan;XIE Ruo-Teng;ZHANG Xue-Ya(Department of Laboratory Medicine,The Second Affliated Hospital of Fujian Medical University,Quanzhou 362000,Fujian Province,China;Department of Hematology,The Second Affliated Hospital of Fujian Medical University,Quanzhou 362000,Fujian Province,China)

机构地区：[1]福建医科大学附属第二医院检验科,福建泉州362000 [2]福建医科大学附属第二医院血液科,福建泉州362000

出　　处：《中国实验血液学杂志》2025年第1期150-156,共7页Journal of Experimental Hematology

基　　金：福建省泉州市科技计划项目(2020N037s)。

摘　　要：目的:探讨血清可溶性白细胞介素-2受体(soluble interleukin-2 receptor,sIL-2R)、肿瘤坏死因子-α(TNF-α)、IgG、IgA对多发性骨髓瘤(multiple myeloma,MM)复发的预测价值。方法:选取2017年1月-2019年3月在本院初诊且治疗的MM患者108例,最终确定符合诊断标准且有完整随访资料的72例患者作为研究对象,以MM复发为研究终点事件,随访至终点事件的发生或本研究随访截止日期。根据是否复发,将MM分为复发组(RG)和非复发组(NRG)。在初诊时和随访后(终点事件的发生或研究终止时)分别采集患者静脉血,酶联免疫吸附测定法(ELISA)检测患者血清中sIL-2R和TNF-α水平;自动免疫分析仪检测患者血清中IgG、IgA水平;比较两组之间各因子表达水平的差异,并分析初诊时和随访后sIL-2R与TNF-α、IgG、IgA之间的相关性。同时在治疗完全缓解时采集患者静脉血,测定血清中sIL-2R水平,比较初诊时、完全缓解时和复发时sIL-2R表达水平的差异。采用受试者工作特征(ROC)曲线判断血清sIL-2R、TNF-α、IgG、IgA的最佳截断值,并根据曲线下面积(AUC)分析sIL-2R、TNF-α、IgG、IgA在MM复发中的预测价值。结果:MM患者初诊时和复发时血清sIL-2R水平均明显高于完全缓解时(P<0.05)。复发组初诊时的血红蛋白(Hb)含量低于未复发组,β2-微球蛋白(β2-MG)含量高于未复发组(P<0.001),两组间的其他临床参数无显著差异(P>0.05)。复发组初诊时和随访后的sIL-2R、TNF-α、IgG、IgA水平均明显高于未复发组(P<0.05),sIL-2R与TNF-α、IgG和IgA在初诊时和随访后均存在显著正相关(P<0.001)。ROC曲线分析结果显示,初诊时sIL-2R、TNF-α、IgG和IgA预测MM的AUC分别为0.919、0.850、0.766和0.795,随访后预测MM的AUC分别为0.890、0.815、0.760和0.794(P<0.001)。结论:血清sIL-2R对MM复发的预测价值最高,可在特定的时间检测TNF-α、IgG和IgA水平来推断sIL-2R水平的变化,从而评估患者的预后。Objective:To investigate the predictive value of serum soluble interleukin-2 receptor(sIL-2R),tumor necrosis factor alpha(TNF-α),IgG and IgA for the recurrence in patients with multiple myeloma(MM).Methods:A total of 108 MM patients who were initially diagnosed and treated in our hospital from January 2017 to March 2019,and72 patients who met the diagnostic criteria and had complete follow-up data were selected as the study subjects.MM recurrence was the endpoint event,and follow-up was conducted until the occurrence of the endpoint event or the deadline of this study.MM patients were divided into recurrent group(RG) and non-recurrent group(NRG) based on whether they have relapsed or not.Venous blood was collected from patients at the first diagnosis and follow-up(at the occurrence of endpoint events or termination of the study),and enzyme-linked immunosorbent assay(ELISA) was used to detect sIL-2R and TNF-α levels in the patient's serum.An automatic immune analyzer was used to detect the levels of IgG and IgA in the patientr s serum.The differences in expression levels of the factors between two groups were compared and the correlations between sIL-2R and TNF-α,IgG and IgA at the first diagnosis and follow-up were analyzed.At the same time,venous blood was collected from patients during complete remission,and their serum sIL-2R levels were measured to compare the differences in sIL-2R expression levels at the first diagnosis,complete remission and recurrence.Receiver operating characteristic(ROC) curves was used to determine the optimal cutoff values for serum sIL-2R,TNF-α,IgG and IgA,and the predictive value of sIL-2R,TNF-α,IgG and IgA in the recurrence of MM patients were analyzed based on the area under the curve(AUC).Results:The serum sIL-2R levels of MM patients at the first diagnosis and recurrence were significantly higher than at complete remission(P <0.05).At the first diagnosis,the hemoglobin content of RG was lower than that of NRG,while the β_2-microglobulin content was higher than that of NRG(

关 键 词：可溶性白细胞介素-2受体 肿瘤坏死因子-α IGG IGA 多发性骨髓瘤 复发 

分 类 号：R733.3[医药卫生—肿瘤]