κ轻链水平与骨髓瘤患者骨痛程度的相关性分析

Analysis of correlation between kappa light chain myeloma and bone pain in patients with kappa light chain myeloma

目的探讨κ轻链型骨髓瘤与其患者骨痛的相关性分析。方法选取2018年1-6月在重庆医科大学附属永川医院血液内科确诊并治疗的多发性骨髓瘤(MM)患者28例,分为κ轻链组(16例)和非κ轻链组(12例)。同时选取同期健康人员15例作为正常对照组,分别于以硼替佐米为主的联合化疗进行κ轻链测定及骨痛评分,然后通过Spearman进行相关性分析,对比分析治疗前后疗效。结果与正常对照组比较,非κ轻链组κ轻链水平差异无统计学意义(P>0.05),但κ轻链组κ轻链水平较非κ轻链组明显增高,κ轻链组骨痛评分明显高于非κ轻链组,差异均有统计学意义(P<0.01);κ轻链组κ轻链水平与其骨痛评分呈显著正相关(P<0.01);经过以硼替佐米为主的联合化疗后,κ轻链组κ轻链水平、骨痛评分较治疗前均明显降低,差异均有统计学意义(P<0.01)。结论硼替佐米通过抑制核因子-κB(NF-κB)通路,进而减少轻链的生成,导致破骨细胞活性减弱,进而溶骨损害减轻,从而缓解骨痛。

Objective To investigate the correlation between bone marrow pain and kappa light chain myeloma.Methods A total of 28 cases of multiple myeloma(MM)patients diagnosed in Hematology Department of Hematology,the Affiliated Yongchuan Hospital,Chongqing Medical University from January to June 2018.The kappa light chain and bone pain score were measured in newly diagnosed patients with kappa light chain myeloma,and then the correlation was analyzed by Spearman.Finally,the kappa light chain and bone pain score were measured and compared before and after bortezomib combined chemotherapy.Results There was no significant difference in the level of kappa light chain between the non-kappa light chain group and the normal control group(P>0.05),but the level of kappa light chain in the non-kappa light chain group was significantly higher than that in the non-kappa light chain group,and the score of bone pain in the kappa light chain group was significantly higher than that in the non-kappa light chain group(P<0.01).After combined chemotherapy with bortezomib,the levels of MM in the kappa light chain group were significantly lower than those before treatment(P<0.01).Conclusion Bortezomib reduces the production of light chain by inhibiting the nuclear factor-kappa B pathway,which leads to the decrease of osteoclast activity and the reduction of osteolytic damage,thereby alleviating bone pain.