1q21扩增与初诊多发性骨髓瘤患者临床特征的相关性及其预后意义

Correlation between 1q21 amplification and clinical features of newly diagnosed multiple myeloma patients and its prognostic significance

目的探讨1q21扩增在初诊多发性骨髓瘤(MM)患者中的发生概率、与临床特征的相关性及其预后意义。方法统计潍坊市人民医院69例初诊MM患者的荧光原位杂交结果,用χ^2检验分析1q21扩增阳性与临床特征的相关性,采用Kaplan-Meier法绘制生存曲线,比较1q21扩增阳性及阴性患者的PFS、OS,评估其预后意义。结果 69例MM患者1q21扩增阳性比例为37.68%.1q21扩增阳性与血红蛋白浓度、β2-微球蛋白浓度、骨髓中浆细胞百分比、血清钙离子浓度、血清肌酐浓度、血清白蛋白浓度、乳酸脱氢酶浓度、DS分期、ISS分期、骨破坏程度无相关性(P>0.05),与其他基因异常:RB1缺失、D13S319缺失、IgH重排有相关性(P<0.05)。1q21扩增阳性组、阴性组中位PFS分别为15.0和19.0个月,中位OS未获得,但组间差异均有显著性(P值分别为0.000和0.023)。结论 1q21扩增与RB1缺失、D13S319缺失、IgH重排有相关性,1q21扩增阳性提示预后不良。

Objective To investigate the occurrence probability,correlation with clinical features and prognostic significance of 1 q21 amplification in newly diagnosed multiple myeloma(MM) patients.Methods The fluorescence in situ hybridization results of 69 newly diagnosed MM patients in Weifang People’s Hospital were analyzed.The correlation between positive 1 q21 amplification and clinical characteristics was analyzed by χ^2 test.The survival curve was drawn by Kaplan-Meier method.The PFS and OS of 1 q21 amplification positive and negative patients were compared to evaluate the prognostic significance.Results The positive rate of 1 q21 amplification in 69 MM patients was 37.68%.There was no statistically correlation between 1 q21 amplification and hemoglobin concentration,β2-microglobulin concentration,plasma cells percentage in bone marrow,serum calcium concentration,serum creatinine concentration,serum albumin concentration,LDH,D-S stage,ISS stage,bone destruction degree(P>0.05),and other gene abnormalities:RB1 deletion,D13 S319 deletion,IgH rearrangement(P<0.05).The median PFS of 1 q21 amplification positive and negative groups were 15.0 and 19.0 months,respectively.The median OS was not obtained,but the difference was statistically significant(P=0.000 and 0.023,respectively).Conclusion 1 q21 amplification is associated with RB1 deletion,D13 S319 deletion,and IgH rearrangement.The positive of 1 q21 amplification indicates a poor prognosis.