新诊断多发性骨髓瘤肾功能亚型组间细胞遗传学及生化特点比较

Cytogenetic and biochemical characteristics comparison between renal function subtypes of newly diagnosed multiple myeloma

目的:分析新诊断多发性骨髓瘤肾功能亚组间细胞遗传学及生化特点。方法:回顾409例新诊断多发性骨髓瘤患者,分析肾功能组间细胞遗传学等生化资料。结果:409例患者中,肾功能不全(renal insufficiency,RI)组占32.2%,与肾功能正常(no-RI)组相比,RI组男女比例、DS分期Ⅲ期、ISS分期Ⅲ期、β2微球蛋白、校正血清钙、乳酸脱氢酶明显增高,RI组血红蛋白、血清白蛋白更低(P均<0.05)。两组免疫分型均以IgG型为主,但no-RI组比例增高,RI组轻链型比例高于no-RI组。多因素Logistic回归分析结果最后显示β2微球蛋白、白蛋白、乳酸脱氢酶是RI发生的危险相关因素。82例进行细胞遗传学检测,RI与no-RI组相比检测阳性率无差异,分别为58.3%和67.2%(P=0.443);在高危细胞遗传学异常中也无明显差异,分别为25%和34.4%(P=0.401)。结论:在新诊断多发性骨髓瘤中肾功能不全与细胞遗传学异常无关,但是与β2微球蛋白、白蛋白、乳酸脱氢酶相关。

Objective:To analyze the cytogenetic and biochemical characteristics of renal function subgroups of newly diagnosed multiple myeloma.Methods:409 patients with newly diagnosed multiple myeloma were reviewed,and the cytogenetics and other biochemical data between renal function groups were analyzed.Results:Among the 409 patients,the renal insufficiency(RI)group accounted for 32.2%.The ratio of male to female,DS stageⅢ,ISS stageⅢ,β2-microglobulin,corrected serum calcium,lactic dehydrogenase in the RI group were significantly higher than those in the no-RI group.In contrast,hemoglobin and serum albumin were lower in the RI group(P<0.05).The immunophenotype of both groups was mainly IgG type,but the proportion of no-RI group was higher than that of RI group.And the proportion of light chain type of RI group was higher than that of no-RI group.The results of multivariate Logistic regression analysis showed thatβ2-microglobulin,albumin and lactic dehydrogenase were risk factors for RI.82 cases were tested by cytogenetics,the positive rates of RI and no-RI were 58.3%and 67.2%(P=0.443),respectively,and there was no significant difference in high-risk cytogenetic abnormalities 25%and 34.4%(P=0.401),respectively.Conclusion:In newly diagnosed multiple myeloma,renal insufficiency is not related to cytogenetic abnormalities,but related toβ2-microglobulin,albumin and lactic dehydrogenase.