多发性骨髓瘤患者血清β2-MG、CRP和IL-6水平与临床分期的关系

Correlation between serumβ2-MG,CRP and IL-6 levels and clinical stage in patients with multiple myeloma

目的探究多发性骨髓瘤(MM)患者血清β2-微球蛋白(β2-MG)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)水平与临床分期的关系。方法选择2014年2月至2019年5月血液科收治的68例初诊MM患者及50例查体的健康志愿者作为研究对象,分别纳入MM组和对照组。测定2组受试者血清β2-MG、CRP和IL-6水平,对MM患者进行Durie-Salmon分期,分析2组患者血清学指标水平差异及其与Durie-Salmon分期的相关性。结果MM组患者血清β2-MG、CRP和IL-6水平高于对照组受试者,差异有统计学意义(P<0.05);随着MM患者临床分期的升高,血清β2-MG、CRP和IL-6水平升高(P<0.05)。Spearman相关性分析示,血清β2-MG、CRP和IL-6水平与临床分期呈正相关(r=0.511,0.305,0.255,P<0.05)。将ISSⅡ期组、ISSⅢ期纳入高分期组,ISSⅠ期组纳入低分期组,ROC曲线分析示,血清β2-MG、CRP和IL-6水平评估高分期患者的曲线下面积(AUC)为0.852、0.651、0.633,当截点值为9.45 mg/L、18.87 mg/L、60.97 pg/L时约登指数最大。β2-MG联合CRP、β2-MG联合IL-6、CRP联合IL-6、三者联合评估MM患者严重程度的AUC分别为0.854、0.873、0.655、0.879,其中三者联合评估价值最高。结论血清β2-MG、CRP和IL-6与MM患者DS分期呈一定程度相关,其中β2-MG相关性最高,对于评估MM患者病情严重程度具有较高的价值,临床可将其单独或联合用于临床中。

Objective To investigate the correlation between the serum levels ofβ2-microglobulin(β2-MG),C-reactive protein(CRP)and interleukin-6(IL-6)and clinical stage in patients with multiple myeloma(MM).Methods A total of 68 patients with MM who were newly diagnosed and treated in our hospital from February 2014 to May 2019 were enrolled as MM group,at the same time,50 healthy subjects who underwent physical examination were enrolled as control group.The serum levels ofβ2-MG,CRP and IL-6 levels were detected,and Durie-Salmon staging was performed for patients with MM.The differences in levels of serum indexes between the two groups and their correlation with Durie-Salmon staging were analyzed.Results The serum levels ofβ2-MG,CRP and IL-6 in MM group were significantly higher than those in control group(P<0.05).With the increase of clinical stage,the serum levels ofβ2-MG,CRP and IL-6 in MM group were significantly increased(P<0.05).Spearman correlation analysis showed that the serum levels ofβ2-MG,CRP and IL-6 were positively correlated with the clinical stage(P<0.05).The patients with ISSII stage and ISSIII stage were enrolled in high stage group and those with ISSI stage were enrolled in low stage group.The ROC curve analysis showed that the areas under the curves(AUC)of serumβ2-MG,CRP and IL-6 levels in evaluation of patients with high stage were 0.852,0.651 and 0.633,respectively.When the cut-off values were 9.45mg/L,18.87mg/L and 60.97pg/L,the Youden index was the largest.Moreover the AUC ofβ2-MG combined with CRP,β2-MG combined with IL-6,CRP combined with IL-6 and the combination of the three indexes in evaluating the severity of MM were 0.854,0.873,0.655 and 0.879,respectively,in which,the value of the combined evaluation of the three indexes was the highest.Conclusion The serum levels ofβ2-MG,CRP and IL-6 are related to the DS stage of patients with MM,in which,β2-MG has the highest correlation,these indexes are of high value in evaluating the severity of MM,which can be used alone or in combination in clinical practice.