多发性骨髓瘤患者血清sFLC、LDH及β2-MG水平及其与预后的关系

Serum sFLC,LDH andβ2-MG levels in patients with multiple myeloma and their relationship with prognosis

目的探讨多发性骨髓瘤(MM)患者血清游离轻链(sFLC)、乳酸脱氢酶(LDH)、β2-微球蛋白(β2-MG)水平及其与预后的关系。方法选取2014年1月至2019年2月四川省第五人民医院收治的94例MM患者及100例体检健康者,测定受试者血清sFLC、LDH及β2-MG水平,随访记录MM患者总生存时间。结果κ-MM组患者sFLC-κ水平及sFLC-κ/sFLC-λ(sFLC-κ/λ)比率显著高于健康对照组(P<0.05);λ-MM组患者sFLC-κ、sFLC-λ水平明显高于健康对照组,sFLC-κ/λ比率低于健康对照组(P<0.05);MM组患者血清LDH及β2-MG水平均显著高于健康对照组(P<0.05)。入组94例患者均获得随访,Kaplan-Meier生存曲线分析显示国际分期系统(ISS)分期、轻链比率、LDH水平与患者总生存时间相关(P<0.05)。Cox多因素分析显示,校正ISS分期等因素后,轻链高比率(sFLC-κ/λ≥100.00或≤0.01)及LDH≥225 U/L是MM患者预后不良的独立危险因素(P<0.05)。结论MM患者存在血清sFLC-κ、sFLC-λ表达异常及LDH、β2-MG水平升高。sFLC-κ/λ比率及LDH水平与MM患者预后相关,可作为判断患者预后的指标。

Objective To investigate the serum free light chain(sFLC),lactate dehydrogenase(LDH),β2-microglobulin(β2-MG)levels in patients with multiple myeloma(MM)and their relationship with prognosis.Methods From January 2014 to February 2019,94 MM patients and 100 healthy people who were admitted to the Fifth People′s Hospital of Sichuan Province were selected.The serum sFLC,LDH andβ2-MG levels of the subjects were measured,and the overall survival time of MM patients was recorded during follow-up.Results The level of sFLC-κand the ratio of sFLC-κ/sFLC-λ(sFLC-κ/λ)in theκ-MM group were significantly higher than those in the healthy control group(P<0.05);the levels of sFLC-κand sFLC-λin theλ-MM group were significantly higher than those in the healthy control group,and the sFLC-κ/λratio was lower than that of the healthy control group(P<0.05);the serum LDH andβ2-MG levels of MM group were significantly higher than those of the healthy control group(P<0.05).A total of 94 patients were followed up,Kaplan-Meier survival curve analysis showed that ISS stage,light chain ratio and LDH level were related to the overall survival time of patients(P<0.05).Cox multivariate analysis showed that after adjusting ISS stage and other factors,high light chain ratio(sFLC-κ/λ≥100.00 or≤0.01)and LDH≥225 U/L were independent risk factors for poor prognosis of MM patients(P<0.05).Conclusion MM patients have abnormal serum sFLC-κ,sFLC-λexpression and elevated levels of LDH andβ2-MG.The sFLC-κ/λratio and LDH level are correlated with the prognosis of MM patients,and can be used as indicators to judge the prognosis of patients.