基于体重指数和HCT-CI评分构建初诊多发性骨髓瘤的预后列线图  

Prognostic nomogram of newly diagnosed multiple myeloma constructed based on body mass index and HCT-CI scores

作　　者：马雪涵 胡光玲 张雅丽 刘蓓[2] MA Xuehan;HU Guangling;ZHANG Yali;LIU Bei(The First Clinical Medical School,Lanzhou University,Lanzhou 730000,China;Department of Hematology,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院血液科,甘肃兰州730000

出　　处：《兰州大学学报(医学版)》2025年第2期25-31,共7页Journal of Lanzhou University(Medical Sciences)

基　　金：甘肃省自然科学基金资助项目(24JRRA297);甘肃省卫生行业科研计划资助项目(GSWSHL2022-26)。

摘　　要：目的分析体重指数和造血干细胞移植合并症指数评分对初诊多发性骨髓瘤患者总生存期的影响并构建列线图。方法回顾性分析189例初诊多发性骨髓瘤患者的基线临床特征,采用单因素及多因素Cox回归筛选初诊多发性骨髓瘤患者预后的影响因素并选择P<0.05的变量构建列线图模型,采用一致性指数、随时间变化的受试者操作特征曲线及曲线下面积和校准图评估其预测性能和准确性。189例初诊多发性骨髓瘤患者分为低体重指数组(≤21 kg/m^(2))和高体重指数组(>21 kg/m^(2))。结果高体重指数组患者的总生存期优于低体重指数组患者的。根据单因素及多因素Cox回归分析结果,将体重指数、造血干细胞移植合并症指数、乳酸脱氢酶、年龄、β2微球蛋白纳入构建列线图模型,其一致性指数为0.713,队列中1、3、5年总生存期的曲线下面积分别为0.767、0.843、0.774,校准曲线和受试者操作特征曲线显示模型有良好的一致性和预测性能。结论本研究构建的列线图模型有助于预测初诊多发性骨髓瘤患者的生存概率。Objective To analyse the effects of body mass index and hematopoietic stem cell transplantationcomorbidity index on overall survival of newly diagnosed multiple myeloma patients and to construct a nomogram.Methods The baseline clinical features of 189 newly diagnosed patients with multiple myeloma were retrospectively analyzed.Key variables were screened by Cox univariate and multifactor,and variables with P<0.05 were screened to construct a nomogram model.Consistency index,receiver operating characteristic curve over time,area under the curve and calibration chart were used to evaluate its performance and prediction accuracy.189 newly diagnosed patients with multiple myeloma were divided into a low body mass index group(≤21 kg/m^(2))and a high body mass index group(>21 kg/m^(2)).Results The overall survival of the high body mass index group was better than that of the low body mass index group.According to the results of Cox univariate and multivariate analysis,body mass index,hematopoietic stem cell transplantation-comorbidity index,lactate dehydrogenase,age and β2 microglobulin were included in the construction of the nomogram model,and the consistency index was 0.713.The area under the curve of 1,3 and 5 year overall survival in the cohort was 0.767,0.843 and 0.774,respectively.Calibration curve and receiver operating characteristic curve showed that the model had good consistency and predictive performance.Conclusion The nomogram model constructed in this study can help to predict the survival probability of newly diagnosed multiple myeloma patients.

关 键 词：多发性骨髓瘤 体重指数 造血干细胞移植合并症指数 预后 列线图 

分 类 号：R733.3[医药卫生—肿瘤]