多发性骨髓瘤患者中POSTN和Ki67表达水平变化及与预后的相关性

Changes of POSTN and Ki67 expression levels in patients with multiple myeloma and their correlation with prognostic

目的检测骨膜蛋白(POSTN)和Ki67在多发性骨髓瘤(MM)患者血浆中的表达水平,并分析其与预后的相关性。方法选取遂宁市中心医院血液科2018年6月-2021年4月收治的88例首次诊断为MM患者作为研究对象,根据R-ISS国际预后分期将MM患者分为Ⅰ期(n=22)、Ⅱ期(n=30)、Ⅲ期(n=36);40名临床基本资料相匹配的健康志愿者作为对照组。采用RT-qPCR法分别测定外周血血浆中POSTN和Ki67表达水平,并随访评估患者预后复发情况,采用生存曲线Kaplan-Meier法和Log-rank检验分析POSTN和Ki67水平与患者预后生存状况的关系。结果与对照组比较,Ⅰ、Ⅱ、Ⅲ期MM患者血清β2微球蛋白和乳酸脱氢酶水平显著升高,白蛋白水平明显降低,差异均有统计学意义(F=244.298、283.843、881.190,P均<0.001);Ⅰ、Ⅱ、Ⅲ期MM患者血浆POSTN和Ki67mRNA水平显著高于对照组,差异均有统计学意义(F=159.068、396.522,P均<0.001)。末次随访,Ⅰ期患者总生存期和无进展生存期分别为(26.41±5.75)月和(23.75±7.25)月,Ⅱ期患者总生存期和无进展生存期分别为(24.57±8.33)月和(20.27±8.87)月,Ⅲ期患者总生存期和无进展生存期分别为(22.19±8.75)月和(17.43±8.63)月。Ⅰ期患者随访期间总生存率为68.18%(15/22),明显高于Ⅱ期63.33%(19/30)和Ⅲ期55.56%(20/36)。Pearson相关性分析显示,患者血浆中POSTN和Ki67 mRNA水平与总生存时间(r=-0.473、-0.385,P均<0.001)和无进展生存时间(r=-0.519、-0.548,P均<0.001)成负相关。结论血浆POSTN和Ki67 mRNA表达水平与MM患者生存时间成负相关,二者对MM患者疾病进展和预后评估具有重要指导意义。

Objective To explore the expression of periostin(POSTN)and Ki67 in the plasma of multiple myeloma(MM)patients and analyze their correlation with prognosis.Methods A total of 88 patients with MM admitted to Suining Central Hospital from June 2018 to April 2021 were retrospectively studied,MM patients were classified as stageⅠ(n=22),stageⅡ(n=30)and stageⅢ(n=36)according to R⁃ISS.Forty healthy volunteers mathched for basic clinical information served as the control group.The expression levels of POSTN and Ki67 in peripheral blood were determined by RT⁃qPCR,and the prognosis and recurrence of the patients were evaluated after 6 months of follow⁃up.The survival curve,Kaplan⁃Meier method and log⁃rank test were used to analyze the POSTN and Ki67 levels and the prognosis and survival status of the two groups of patients.Results The levels of serumβ2 microglobulin and lactate dehydrogenase in MM patients of stageⅠ,ⅡandⅢwere significantly higher than those in the control group,while the levels of albumin were significantly lower,the differences were statistically significant(F=244.298,283.843,881.190;all P<0.001).The levels of plasma POSTN and Ki67 mRNA were significantly higher than those in the control group,the differences were statistically significant(F=159.068,396.522;all P<0.05).At the last follow⁃up,the overall survival and progression⁃free survival in stageⅠpatients were(26.41±5.75)months and(23.75±7.25)months,respectively;those in stageⅡpatients were(24.57±8.33)months and those in stageⅢpatients were(20.27±8.87)months,and those in stageⅢpatients were(22.19±8.75)months and those in stageⅢpatients were(17.43±8.63)months.The overall survival rate of stageⅠpatients was 68.18%(15/22),which was significantly higher than that of stageⅡpatients(63.33%,19/30)and stageⅢpatients(55.56%,20/36).Pearson correlation analysis showed that plasma POSTN and Ki67 mRNA levels were significantly negatively correlated with overall survival time(r=-0.473,-0.385;all P<0.001)and progression⁃free survival time(r=-0.519,-0.548;all P<0.001).Conclusions The levels of plasma POSTN and Ki67 mRNA were significantly negatively correlated with the survival time of MM patients,which had important guiding significance for the evaluation of disease progression and prognosis of MM patients.