骨髓单个核细胞热休克蛋白27表达在多发性骨髓瘤中的临床价值

The clinical value of HSP27 expression of bone marrow mononuclear cells in multiple myeloma

目的探讨骨髓单个核细胞热休克蛋白27(HSP27)表达与多发性骨髓瘤(MM)临床特征的关系。方法收集初治多发性骨髓瘤患者86例,复发难治患者27例,对照组为非血液系统恶性肿瘤患者,根据治疗方案的不同,MM患者分为初治组、复发难治常规化疗组及含硼替佐米化疗组。分别于化疗前、化疗后1、2、3疗程检测骨髓单个核细胞HSP27的表达率及蛋白水平。结果化疗前各组HSP27表达量及蛋白水平趋势为:复发难治组大于初治组大于对照组。初治组中Ⅲ期患者的HSP27明显高于Ⅱ期患者。含硼替佐米化疗方案可明显降低HSP27的表达及蛋白水平,含硼替佐米化疗方案抑制HSP27的表达力度明显优于常规化疗组。化疗后1个疗程HSP27的表达量小于1的患者,其死亡率、复发率明显低于HSP27表达量大于1的患者,且复发时间明显延后。结论骨髓单个核细胞HSP27的表达及蛋白水平与多发性骨髓瘤的分期、治疗应答、预后相关。

Objective To investigate the relationship of HSP27 expression with treatment response,remission rate,prognosis in multiple myeloma（MM） patients. Methods Eighty-six patients with MM first diagnosis and 27 relapse cases were collected respectively. Control was defined as non-hematological malignance. The MM patients divided into first diagnosis, relapse conventional chemotherapy group and bortezomib group. HSP27 expression and protein level were measured on pre-and post 1,2 and 3 treatment circles. Results The tendency of HSP expression and protein level： relapse-MM patients〉first-diagnosis MM patients 〉control. HSP27 expression and level in Ⅲ phase was higher than those in Ⅱ phase for first-diagnosis MM patients. Bortizomib-containing chemotherapy protocol showed more effectively decrease on HSP27 than chemotherapy treatment only. At post-1 treatment circle, HSP27〈1 showed higher survival rate than HSP27〉1 and delayed the relapse time. Conclusion BMMNC-HSP27 expression and protein level is associated with staging,treatment response and prognosis in MM patients.