初诊多发性骨髓瘤患者外周血CD31、CD45表达与肿瘤分期和预后的关系

Relationship between peripheral blood CD31,CD45 and tumor staging,prognosis in patients with newly diagnosed multiple myeloma

目的 探讨初诊多发性骨髓瘤(MM)患者外周血CD31、CD45表达与肿瘤分期和预后的关系。方法 选取2017年1月至2021年4月盐城市第三人民医院收治的95例初诊MM患者,根据外周血CD31、CD45表达情况分为CD31阳性表达78例、CD31阴性表达17例和CD45阳性表达30例、CD45阴性表达65例。收集初诊MM患者年龄、性别、国际分期系统(ISS)分期等一般资料,统计随访1年的无进展生存率和总生存率。采用流式细胞仪检测外周血CD31、CD45表达,比较外周血CD31、CD45表达与临床特征的关系;采用Spearman相关分析外周血CD31、CD45表达与ISS分期的关系,采用Kaplan-Meier生存曲线分析外周血CD31、CD45表达与初诊MM患者无进展生存率和总生存率的关系,采用Cox比例风险回归模型分析影响初诊MM患者预后的因素。结果 外周血CD31、CD45表达与初诊MM患者年龄、ISS分期、骨骼损伤和骨髓浆细胞比例有关(P<0.05)。Spearman相关分析结果显示,外周血CD31、CD45表达与初诊MM患者ISS分期呈正相关(P<0.05)。Kaplan-Meier生存曲线分析结果显示,外周血CD31、CD45阳性表达患者总生存率和无进展生存率分别低于CD31、CD45阴性表达患者(P<0.05)。Cox比例风险回归模型分析结果显示,ISS分期Ⅲ期和CD31、CD45阳性表达均为影响初诊MM患者总生存率的独立危险因素(P<0.05)。结论 初诊MM患者外周血CD31、CD45均为阳性表达,且与ISS分期呈正相关,ISS分期Ⅲ期和CD31、CD45阳性表达是影响初诊MM患者总生存率的独立危险因素。

Objective To investigate the expression of CD31 and CD45 in peripheral blood of patients with newly diagnosed multiple myeloma(MM)and its relationship with tumor stage and prognosis.Methods Totally 95 newly diagnosed MM patients admitted to Yancheng Third People′s Hospital from January 2017 to April 2021 were selected.According to the expression of CD31 and CD45 in peripheral blood,they were divided into CD31 positive expression(78 cases),CD31 negative expression(17 cases),CD45 positive expression(30 cases)and CD45 negative expression(65 cases).The clinical data of newly diagnosed MM patients,including age,gender,international staging system(ISS)staging were collected.The progression-free survival rate and overall survival rate at 1-year follow-up were analyzed.Spearman correlation analysis was used to analyze the relationship between the expression of CD31 and CD45 in peripheral blood and ISS stage.Kaplan-Meier survival curve was used to analyze the relationship between the expression of CD31 and CD45 in peripheral blood and progression-free survival and overall survival of newly diagnosed MM patients.Cox proportional hazards regression model was used to analyze the prognostic factors of newly diagnosed MM patients.Results The expression of CD31 and CD45 in peripheral blood was related to age,ISS stage,bone injury and the proportion of bone marrow plasma cells in newly diagnosed MM patients(P<0.05).Spearman correlation analysis showed that the expression of CD31 and CD45 in peripheral blood was positively correlated with ISS stage of newly diagnosed MM patients.Kaplan-Meier survival curve analysis showed that the overall survival rate and progression-free survival rate of patients with positive expression of CD31 and CD45 in peripheral blood were significantly lower than those of patients with negative expression of CD31 and CD45(P<0.05).Cox proportional hazards regression model analysis showed that ISS stageⅢand positive expression of CD31 and CD45 were independent risk factors affecting the overall survival rate of newly diagnosed MM patients(P<0.05).Conclusion The expression of CD31 and CD45 in peripheral blood of newly diagnosed MM patients is positive,which is positively correlated with ISS stage.ISS stageⅢand positive expression of CD31 and CD45 are independent risk factors for the overall survival rate of newly diagnosed MM patients.