多发性骨髓瘤患者血清sICAM-1、sVCAM-1、Treg水平与预后的相关性分析

Correlation between levels of serum sICAM-1,sVCAM-1 and Treg and prognosis in patients with multiple myeloma

目的:研究多发性骨髓瘤(MM)患者血清可溶性内皮细胞间黏附因子-1(sICAM-1)、可溶性血管细胞黏附因子-1(sVCAM-1)和调节性T细胞(Treg细胞)水平与预后的相关性。方法:选取2013年6月—2015年6月就诊的MM患者127例和健康体检者100例,分别作为研究组和对照组,检测MM患者入院第1天和对照组体检时血清sICAM-1、sVCAM-1和Treg细胞水平并进行比较,MM患者均给予VCD方案化疗至少治疗4个周期并随访预后,分析各指标与患者预后的关系。结果:研究组血清sICAM-1、sVCAM-1和Treg细胞水平高于对照组,死亡组MM患者sICAM-1、sVCAM-1及Treg细胞水平高于存活组,差异有统计学意义(P<0.05);受试者工作曲线分析显示,血清sICAM-1、sVCAM-1和Treg细胞评估MM患者预后的曲线下面积分别为0.875、0.679和0.816,以sICAM-1≥408.33μg/L、sVCAM-1≥882.48μg/L和Treg细胞≥6.13%为截断值时,灵敏度分别为76.06%、74.65%和71.73%,特异度分别为89.29%、57.14%和87.50%;血清sICAM-1≥408.33μg/L、sVCAM-1≥882.48μg/L和Treg细胞≥6.13%的MM患者中位总体生存时间分别为48、51和48个月,较血清sICAM-1<408.33μg/L、sVCAM-1<882.48μg/L和Treg细胞<6.13%者明显缩短(P<0.05)。结论:MM患者血清sICAM-1、sVCAM-1和Treg细胞水平明显升高,且可对患者预后造成不利影响,可为MM治疗和预后评估提供参考依据。

Objective:To study the correlation between levels of serum soluble intercellular adhesion molecule-1(sICAM-1),soluble vascular cell adhesion molecule-1(sVCAM-1)and regulatory T cells(Treg cells)and prognosis in patients with multiple myeloma(MM).Methods:From June 2013 to June 2015,127 MM patients and 100 healthy people with physical examination in our hospital were selected as study group and control group respectively,and the levels of serum sICAM-1,sVCAM-1 and Treg cells were detected and compared among MM patients on the 1std of admission and in control group at physical examination.MM patients were given VCD regimen chemotherapy for at least 4 cycles and follow-up prognosis,and the relationship between each index and prognosis was analyzed.Results:The levels of serum sICAM-1,sVCAM-1 and Treg cells in study group were higher than those in control group,and the levels of sICAM-1,sVCAM-1 and Treg cells of MM patients in death group were higher than those in survival group(P<0.05).ROC curve analysis showed that the AUC values of serum sICAM-1,sVCAM-1 and Treg cells in evaluating the prognosis of MM patients were 0.875,0.679 and 0.816 respectively.With sICAM-1 ≥408.33μg/L,sVCAM-1 ≥882.48μg/L and Treg cells ≥6.13% as the cut-off values,the sensitivities were 76.06%,74.65%,and 71.73%,and the specificities were 89.29%,57.14%,and 87.50%.The median OS times of MM patients with serum sICAM-1 ≥408.33μg/L,sVCAM-1 ≥882.48μg/L and Treg cells ≥6.13% were 48,51,and 48 months respectively,which were obviously shortened compared with those of serum sICAM-1 <408.33μg/L,sVCAM-1<882.48μg/L and Treg cells <6.13%(P<0.05).Conclusion:The levels of serum sICAM-1,sVCAM-1 and Treg cells in patients with MM were significantly increased,and could adversely affect the prognosis of patients and provide a reference for the treatment and prognosis evaluation of MM.