红细胞分布宽度在多发性骨髓瘤患者预后分期中的价值

Value of Red Cell Distribution Width in the Prognosis of Patients with Multiple Myeloma

目的探讨多发性骨髓瘤(MM)患者红细胞分布宽度(RDW)与预后分期的关系。方法以27例初诊MM患者和30例正常人为研究对象,根据血细胞检测结果计算得出RDW,比较两组RDW的差异;对MM患者进行国际标准分期(ISS),分析RDW在不同分期间的差异;用ISS分期进行分组,绘制受试者工作曲线(receiver operating characteristic curve,ROC曲线),取RDW 14.65%作为最佳截点,把MM患者分为低RDW组(RDW≤14.65%)和高RDW组(RDW>14.65%),分析两组患者总体生存期(OS)的差异。生存分析采用Kaplan-Meier法和Log-rank检验。结果实验组和对照组RDW水平分别为(15.60±2.35)%vs(12.72±0.61)%,差异具有统计学意义(t=6.201,P<0.001);低ISS分期(Ⅰ+Ⅱ期)和高ISS分期(Ⅲ期)间RDW水平分别为(13.99±1.08)%vs(16.55±2.39)%,差异有统计学意义(t=3.800,P=0.001);低RDW组和高RDW组的中位生存时间分别为13个月和8个月,差异有统计学意义(X^2=6.481,P=0.011)。结论 RDW增高的MM患者,其危险分层更高,预后更差。

Objective To investigate the relationship between red blood cell distribution width （RDW） and prognosis in patients with multiple myeloma （MM）. Methods The population that studied consisted of 27 patients with multiple myeloma and 30 healthy controls. The RDW was calculated according to the results of blood routine examination and compared be tween patients and healthy controls. Then, compared the difference between the two groups of RDW. MM patients were treated with international standard staging （ISS） ,and the differences of RDW in different stages were analyzed. ISS staging was used to draw the receiver operating curve （receiver operating characteristic curve, ROC curve）, then take RDW14.65 % as the best cut-off point,the MM patients were divided into low RDW group （RDW=14.65%） and high RDW group （RDW 〉14.65%）. Overall survival （OS） condition were compared between the above two groups. The impacts of RDW on OS were analyzed by Kaplan-Meier and Log-rank test. Results The average RDW value in experimental and controlled were 15.60 ± 2.35 % vs 12.72% ± 0.61% separately （t=6. 201, P〈0. 001 ）, with statistical differences. The average RDW val ue in low ISS（ Ⅰ＋Ⅱ stage） and high ISS （Ⅲ stage） were 13.99%±1.08% vs 16.55±2.39% separately （t=3. 800,P= 0. 001）. The median survival time of low RDW and high RDW group was 13 months and 8 months respectively, and the difference was statistically significant （X^2 = 6. 481, P = 0. 011 ）. Conclusion RDW increased in patients with MM, the risk stratification higher prognosis is worse.