血清游离轻链比与多发性骨髓瘤预后的相关性

Clinical analysis of the prognostic value of baseline serum free light chain ratio in multiple myeloma

目的分析血清游离轻链比(sFLCR)在多发性骨髓瘤预后中的影响。方法回顾2005年12月至2009年4月我院40例多发性骨髓瘤患者的临床资料,将多发性骨髓瘤患者中λ型sFLCR>42.26或κ型sFLCR>7.91归为高sFLCR组,将λ型sFLCR≤42.26或κ型sFLCR≤7.91归为低sFLCR组,评估两组患者的预后及相关临床指标。结果高sFLCR组患者中位年龄、骨髓中浆细胞比例、分期均高于低sFLCR组,低sFLCR组患者生存时间较高sFLCR组患者长。在排除sFLCR的影响后,β2-微球蛋白对预后有影响;在不同sFLCR组中,不同的浆细胞比例对生存期的影响不同。结论血清游离轻链比的高低能够初步预示多发性骨髓瘤的预后。

Objective Analysis of the prognostic value of baseline serum free light chain ratio （sFLCR） in multiple myeloma（MM）.Methods Clinical data of 40 patients with multiple myeloma were retrospectively reviewed from December 2005 to April 2009 in our department.According to our hospital data,median baseline sFLCR was 42.26 in λ-MM patients,and 7.91 in κ-MM patients.sFLCR was categorised as low （ 〈observed median value） or high （≥observed median value）.Results The study showed that the median age,the proportion of plasma cells in bone marrow,disease stages were higher in the patients with high sFLCR than the patients with low sFLCR;the high sFLCR were strongly correlated with survival.Excluding the effect of sFLCR,β2-microglobulin had impact on the survival time.In the low or high sFLCR group,the proportion of plasma cells had different effects on survival.Conclusion The level of sFLCR may indicate the initial prognosis of multiple myeloma.