CD269在多发性骨髓瘤患者中的表达及预后价值分析  

Analysis of expression and prognostic value of CD269 in patients with multiple myeloma

作　　者：赵菁 宋旖川 司旭 傅雯萱 张瑞[1] Zhao Jing;Song Yichuan;Si Xu;Fu Wenxuan;Zhang Rui(Department of Clinical Laboratory,Beijing Chaoyang Hospital,Capital Medical University,Beijing100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院检验科,北京100020

出　　处：《中华检验医学杂志》2025年第1期133-141,共9页Chinese Journal of Laboratory Medicine

基　　金：北京市医院管理局临床医学发展专项经费资助“扬帆”计划重点医学专业(ZYLX20213);北京市高层次公共卫生技术人才(2022-3-022)。

摘　　要：目的分析B细胞成熟抗原(CD269)在新诊断多发性骨髓瘤(NDMM)患者骨髓瘤细胞上的表达,并评估其在患者中的预后价值。方法本研究为回顾性队列研究。研究对象为2018年10月23日至2023年12月25日期间,就诊于首都医科大学北京朝阳医院门诊和病房的154例NDMM患者,其中男性90例,女性64例,年龄60(55,66)岁。通过流式细胞术(FCM)对骨髓样本中骨髓瘤细胞进行CD269免疫表型分析,根据其表达将患者分为CD269阳性组(表达>20%,103例)与CD269阴性组(表达≤20%,51例),首先评估CD269表达对NDMM患者无进展生存期(PFS)的影响,采用横断面分析,比较临床基本特征、32项实验室指标与5项细胞遗传学指标在两组间的差异;进一步分析不同指标分别对CD269阳性组与阴性组患者PFS的影响,并运用Cox比例风险回归模型分析CD269表达与其他疾病相关指标对患者PFS的影响。结果在154例NDMM患者中,CD269阳性患者103/154例(66.9%),CD269阴性患者51/154例(33.1%),两组患者临床基本特征差异均无统计学意义。CD269阳性组患者PFS低于CD269阴性组患者[28.0(18.0,41.0)个月比35.0(27.0,-)个月,风险比为2.012,95%CI 1.059~3.824,χ^(2)=4.554,P=0.033];Cox比例风险回归显示CD269阳性与非IgG亚型是MM患者PFS的独立危险因素(HR=2.395,95%CI 1.152~4.979,P=0.019;HR=0.425,95%CI 0.223~0.810,P=0.009)。CD269阳性组中,年龄>65岁、非IgG亚型、国际分期体系(ISS)为Ⅲ期、β2-微球蛋白(β2-MG)≥5.5 mg/L、t(11;14)异常与存在≥3个细胞遗传学异常患者的PFS明显缩短(P<0.05)。结论CD269阳性是NDMM患者PFS的独立危险因素,其中高龄、非IgG亚型、ISSⅢ期、血清β2-MG含量较高、t(11;14)异常、存在≥3个细胞遗传学异常均会影响CD269阳性患者PFS。ObjectiveThis study aimed to analyze the expression of B-cell maturation antigen(CD269)on myeloma cells in patients with newly diagnosed multiple myeloma(NDMM)and evaluate its prognostic value.MethodsThe retrospective analysis was conducted on the clinical data of 154 NDMM patients admitted to the outpatient clinics and wards of Beijing Chaoyang Hospital,Capital Medical University from October 23,2018 to December 25,2023,including 90 males and 64 females,aged 60(55,66)years old.CD269 phenotype was analyzed using flow cytometry(FCM).Specifically,patients were divided into CD269 positive group(expression>20%,n=103)and CD269 negative group(expression≤20%,n=51)based on the flow cytometry prior to treatment.Initially,we assessed the effect of CD269 expression on progression-free survival(PFS)in patients with NDMM and compared the two groups.Through a cross-sectional analysis,we examined the basic clinical characteristics,32 laboratory indicators,and 5 cytogenetic indicators.We identified differences between the two groups and analyzed the impact of various indicators on the PFS of patients in both the CD269 positive and negative groups.Furthermore,we employed the Cox proportional hazards regression model to evaluate the influence of CD269 expression and other disease-related indicators on patients′PFS.ResultsAmong 154 NDMM patients,103 were identified as CD269 positive(66.9%),while 51 were CD269 negative(33.1%).No statistically significant differences in clinical indicators were observed between the two groups.The PFS for CD269 positive group was significantly lower than it in the CD269 negative group[28.0(18.0,41.0)months vs 35.0(27.0,-)months,HR=2.012,95%CI 1.059-3.824,χ^(2)=4.554,P=0.033].Cox proportional hazards regression analysis indicated that CD269 positivity and non-IgG subtypes were independent risk factors influencing PFS in NDMM patients(HR=2.395,95%CI 1.152-4.979,P=0.019;HR=0.425,95%CI 0.223-0.810,P=0.009).In the CD269 positive group,progression-free survival(PFS)was significantly shortened in patien

关 键 词：多发性骨髓瘤 CD269 预后分析 流式细胞术 实验室指标 细胞遗传学 

分 类 号：R733.3[医药卫生—肿瘤]