血清高迁移率族蛋白B1、β_(2)-微球蛋白、乳酸脱氢酶及白细胞介素-6在多发性骨髓瘤中的表达及相关性

Expression and correlation of serum high mobility group protein B1,β_(2)-microglo-bulin,lactate dehydrogenase,and interleukin-6 in multiple myeloma

目的 探讨血清高迁移率族蛋白B1(HMGB1)、β_(2)-微球蛋白(β_(2)-MG)、乳酸脱氢酶(LDH)及白细胞介素-6(IL-6)在多发性骨髓瘤中的表达及相关性。方法 选取60例健康体检者和86例多发性骨髓瘤患者,其中31例初诊未治,55例接受硼替佐米+地塞米松+沙利度胺(BDT)方案化疗。比较多发性骨髓瘤患者与体检者、初诊未治与BDT方案治疗不同临床疗效患者、不同临床分期初诊未治多发性骨髓瘤患者血清HMGB1、β_(2)-MG、LDH、IL-6水平。血清HMGB1水平与β_(2)-MG、LDH、IL-6水平的相关性采用Pearson相关分析。结果 多发性骨髓瘤患者血清HMGB1、β_(2)-MG、LDH及IL-6水平均明显高于体检者,差异均有统计学意义(P﹤0.01)。初诊未治及无效患者血清HMGB1、β_(2)-MG、LDH、IL-6水平均明显高于有效患者,无效患者血清HMGB1、β_(2)-MG、LDH、IL-6水平均明显高于初诊未治患者,差异均有统计学意义(P﹤0.01)。临床分期为Ⅱ、Ⅲ期的初诊未治多发性骨髓瘤患者血清HMGB1、β_(2)-MG、LDH、IL-6水平均明显高于Ⅰ期患者,Ⅲ期患者的血清HMGB1、β_(2)-MG、LDH、IL-6水平均明显高于Ⅱ期患者,差异均有统计学意义(P﹤0.01)。Pearson相关分析显示,血清HMGB1水平与β_(2)-MG、LDH、IL-6水平均呈正相关(r=0.902、0.867、0.882,P﹤0.05)。结论 多发性骨髓瘤患者血清HMGB1水平较高,BDT方案治疗后可使其显著降低,且与β_(2)-MG、LDH、IL-6水平均呈正相关,临床可联合HMGB1、β_(2)-MG、LDH、IL-6共同作为评估多发性骨髓瘤疾病严重程度和治疗效果的分子靶点。

Objective To analyze the expression and correlation of serum high mobility group protein B1(HMGB1),β_(2)-microglobulin(β_(2)-MG),lactate dehydrogenase(LDH),and interleukin-6(IL-6) in multiple myeloma.Method A total of 60 healthy subjects and 86 patients with multiple myeloma were selected,of which 31 were newly diagnosed and untreated and 55 received bortezomib + dexamethasone + thalidomide(BDT) regimen chemotherapy.The serum levels of HMGB1,β_(2)-MG,LDH and IL-6 were compared in multiple myeloma patients and healthy subjects,newly diagnosed and untreated patients and BDT treated patients with different clinical effects,and newly diagnosed and untreated patients with multiple myeloma at different clinical stages.The correlation of serum HMGB1 with β_(2)-MG,LDH and IL-6 were determined by Pearson correlation analysis.Result The levels of serum HMGB1,β_(2)-MG,LDH and IL-6 in multiple myeloma patients were significantly higher than those in healthy subjects(P<0.01).The levels of serum HMGB1,β_(2)-MG,LDH and IL-6 in newly diagnosed and untreated patients and ineffective patients were significantly higher than those in the effective patients,while the serum levels of HMGB1,β_(2)-MG,LDH,and IL-6 in ineffective patients were significantly higher than those in the newly diagnosed and untreated patients(P<0.01).The levels of serum HMGB1,β_(2)-MG,LDH,and IL-6 in the newly diagnosed and untreated multiple myeloma patients at clinical stages Ⅱ and Ⅲ were significantly higher than those at clinical stage Ⅰ,and serum levels of HMGB1,β_(2)-MG,LDH and IL-6 in patients at clinical stage Ⅲ were significantly higher than those at clinical stage Ⅱ(P<0.01).Pearson correlation analysis showed that serum levels of β_(2)-MG,LDH,and IL-6 were positively correlated with HMGB1 level(r=0.902,0.867,0.882,P<0.05).Conclusion Multiple myeloma patients have higher serum HMGB1 levels,which can be significantly reduced after BDT treatment,the levels of β_(2)-MG,LDH,and IL-6 are positively correlated with HMGB1 level,and can be combined clinically HGGB1,β_(2)-MG,LDH,and IL-6 are collectively used as molecular targets to evaluate the severity and treatment efficacy of multiple myeloma.