多发性骨髓瘤外周血CMCs水平与并发髓外浸润的关系分析

Analysis of relationship between CMCs level in peripheral blood and concurrent extramedullary infiltration among patients with multiple myeloma

目的探讨多发性骨髓瘤外周血循环骨髓瘤细胞(CMCs)水平与并发髓外浸润的关系。方法选择2021年2月—2023年7月本院收治的多发性骨髓瘤患者80例作为研究对象,根据患者初诊时是否并发髓外浸润将其进一步分为并发组(16例)和未并发组(64例)两组。比较两组外周血CMCs水平和一般资料,采用Logistic回归分析法分析多发性骨髓瘤患者并发髓外浸润的影响因素,并应用受试者工作特征曲线(ROC)分析外周血CMCs水平对多发性骨髓瘤患者并发髓外浸润的诊断价值。结果并发组外周血CMCs、乳酸脱氢酶(LDH)、β2微球蛋白(β2MG)水平均高于未并发组(P<0.05);经Logistic回归分析显示,CMCs、LDH、β2MG升高均是多发性骨髓瘤患者并发髓外浸润的危险因素(P<0.05);经ROC曲线分析显示,外周血CMCs、LDH、β2MG单项及联合对多发性骨髓瘤患者并发髓外浸润诊断的灵敏度分别为93.75%、87.50%、81.25%、75.00%,特异度分别为85.94%、81.25%、84.38%、89.06%,曲线下面积(AUC)分别为0.928、0.898、0.848、0.931。结论多发性骨髓瘤并发髓外浸润患者外周血CMCs水平较高,是多发性骨髓瘤患者并发髓外浸润的危险因素,并且对患者并发髓外浸润的具有一定诊断价值。

Objective To investigate the relationship between the level of circulating myeloma cells(CMCs)in peripheral blood and extramedullary infiltration among patients with multiple myeloma.Methods A total of 80 patients with multiple myeloma who were admitted to our hospital from February 2021 to July 2023 were selected as the research objects.According to whether the patients were complicated with extramedullary infiltration at the initial diagnosis,they were further divided into the concurrent group(n=16)and the non-concurrent group(n=64).The levels of CMCs in peripheral blood and general data were compared between the two groups.The influencing factors of extramedullary infiltration in patients with multiple myeloma was analyzed by Logistic regression analysis.The diagnostic value of CMCs levels in peripheral blood of patients with multiple myeloma complicated with extramedullary infiltration was analyzed by the receiver operating characteristic(ROC)curve.Results The levels of CMCs,lactate dehydrogenase(LDH)andβ2 microglobulin(β2MG)in peripheral blood of the concurrent group were higher than those of the non-concurrent group(P<0.05).Logistic regression analysis showed that the increase of CMCs,LDH andβ2MG were risk factors for extramedullary infiltration in patients with multiple myeloma(P<0.05).ROC curve analysis showed that the sensitivity of CMCs in peripheral blood,LDH,β2MG and their combination in the diagnosis of extramedullary infiltration in patients with multiple myeloma were 93.75%,87.50%,81.25%and 75.00%,and the specificity was 85.94%,81.25%,84.38%and 89.06%,and the area under the curve(AUC)was 0.928,0.898,0.848 and 0.931,respectively.Conclusions The level of CMCs in peripheral blood of patients with multiple myeloma complicated with extramedullary infiltration is higher,which is a risk factor for extramedullary infiltration in patients with multiple myeloma,and has certain diagnostic value for patients with extramedullary infiltration.