血清β2-MG、Cys-C、DKK1联合检测对多发性骨髓瘤患者预后的预测价值

Predictive value of joint detection of serumβ2-MG,Cys-C,and DKK1 in prognosis of patients with multiple myeloma

目的:分析多发性骨髓瘤患者血清β2-微球蛋白(β2-MG)、膀抑素C(Cys-C)、Dickkopf-1(DKK1)表达水平及对其预后的预测价值。方法:选取郑州市金水区总医院2019年6月—2023年6月收治的多发性骨髓瘤患者101例为研究组,另选取同期健康体检者76例为对照组。比较2组入院时血清β2-MG、Cys-C、DKK1水平;分析血清β2-MG、Cys-C、DKK1水平与多发性骨髓瘤患者Durie Salmon(D-S)分期、ISS分期的相关性;分析血清β2-MG、Cys-C、DKK1水平联合检测对多发性骨髓瘤患者预后的预测价值。结果:入院时,研究组血清β2-MG、Cys-C、DKK1水平分别为(8.31±0.81)mg/L、(1.71±0.31)mg/L、(8.61±1.86)ng/L,高于对照组的(1.53±0.57)mg/L、(0.72±0.17)mg/L、(2.76±1.41)ng/L,差异均有统计学意义(P<0.05)。D-S分期Ⅲ期多发性骨髓瘤患者血清β2-MG、Cys-C、DKK1水平分别为(8.78±1.88)mg/L、(1.92±0.57)mg/L、(9.13±1.77)ng/L,高于D-S分期Ⅰ~Ⅱ期患者的(7.56±1.57)mg/L、(1.37±0.36)mg/L、(7.78±1.59)ng/L,差异均有统计学意义(P<0.05);ISS分期Ⅲ期多发性骨髓瘤患者血清β2-MG、Cys-C、DKK1水平分别为(9.32±1.67)mg/L、(2.56±0.73)mg/L、(9.33±1.11)ng/L,高于ISS分期Ⅰ~Ⅱ期患者的(7.62±1.54)mg/L、(1.20±0.43)mg/L、(8.12±1.71)ng/L,差异均有统计学意义(P<0.05)。血清β2-MG、Cys-C、DKK1水平与D-S分期、ISS分期均呈正相关(P<0.001)。治疗3个月后,治疗无效组血清β2-MG、Cys-C、DKK1水平高于治疗有效组,差异均有统计学意义(P<0.05)。血清β2-MG、Cys-C、DKK1水平联合检测预测多发性骨髓瘤患者预后的AUC、敏感度、特异度分别为0.822、83.91%、92.86%。结论:多发性骨髓瘤患者血清β2-MG、Cys-C、DKK1处于较高水平,三者联合检测对多发性骨髓瘤患者的预后具有较好的预测价值,可作为判断疗效和预后的血清学指标。

Objective:To analyze the expression level ofβ2-microglobulin(β2-MG),Cystatin C(Cys-C),and Dickkopf-1(DKK1)and its predictive value in prognosis of patients with multiple myeloma.Methods:101 patients with multiple myeloma admitted to Jinshui General Hospital of Zhengzhou from June 2019 to June 2023 were included in this study as an observation group,and another 76 healthy adults at the same period were chosen as a control group.Serum levels ofβ2-MG,Cys-C,and DKK1 of the 2 groups on admission were compared.Correlation of serum levels ofβ2-MG,Cys-C,and DKK1 with Durie Salmon(D-S)staging and ISS staging was observed and predictive value in prognosis of patients with multiple myeloma was appraised.Results:On admission,the serum levels ofβ2-MG,Cys-C,and DKK1 of the observation group were respectively(8.31±0.81)mg/L,(1.71±0.31)mg/L and(8.61±1.86)mg/L,higher than those of the control group’s(1.53±0.57)mg/L,(0.72±0.17)mg/L and(2.76±1.41)mg/L(P<0.05).In stage III of D-S staging,serum levels ofβ2-MG,Cys-C,and DKK1 of the patients with multiple myeloma were(8.78±1.88)mg/L,(1.92±0.57)mg/L and(9.13±1.77)mg/L respectively,higher than those of stages I-II patients’(7.56±1.57)mg/L,(1.37±0.36)mg/L and(7.78±1.59)mg/L(P<0.05).Serum levels ofβ2-MG,Cys-C,and DKK1 were positively correlated with D-S staging and ISS staging(P<0.001).After 3 months’treatment,serum levels ofβ2-MG,Cys-C,and DKK1 in the ineffective group were higher than those in the effective group(P<0.05).The AUC,sensitivily and specificity of joint detection of serum levels ofβ2-MG,Cys-C,and DKK1 in prediction of the prognosis of the patients with multiple myeloma were 0.822,83.91%and 92.86%respectively,higher than the separate detection of the three(P<0.05).Conclusion:Serumβ2-MG,Cys-C,and DKK1 in patients with multiple myeloma are at a relatively high level.Joint detection of the three possesses good predictive value in the prognosis of the patients,which can be taken as serological markers in the judgement of therapeutic effect and prognosis.