骨髓涂片联合CRP,LDH对多发性骨髓瘤诊断及病情评估的价值分析

Analysis of the Value of Bone Marrow Smear Combined with CRP and LDH Indicators for the Diagnosis and Disease Assessment of MM

目的探讨骨髓涂片联合CRP,LDH指标对多发性骨髓瘤(MM)诊断及病情评估的价值。方法选取72例被确诊为MM的患者,同期选择因其他原因接受骨髓穿刺的30例患者为对照组,比较2组患者的骨髓涂片等差异。结果研究组骨髓浆细胞占比及血清LDH、CRP水平均明显高于对照组(P<0.05);对照组、MMⅠ期、MMⅡ期、MMⅢ期患者的骨髓浆细胞占比及血清LDH、CRP水平逐渐增高(P<0.05);原始、幼稚浆细胞型患者血清LDH、CRP水平分别高于成熟浆细胞型(P<0.05)。ROC曲线分析:骨髓涂片、血清LDH和CRP水平联合诊断MM的AUC最大(0.913),诊断效能良好,最佳敏感度、特异度分别为91.6%、85.6%。结论骨髓涂片、血清LDH和CRP水平联合诊断MM的价值较大,有助于提高此病诊断的敏感性和准确性。

Objective To investigate the value of bone marrow smear combined with CRP and LDH indicators for the diagnosis and disease assessment of MM.Methods 72 patients diagnosed with MM,and 30 patients who underwent bone marrow aspiration for other reasons were selected as the control group during the same period,compared the differences in bone marrow smears and other differences between the 2 groups.Results The percentage of bone marrow plasma cells and serum LDH and CRP levels in the study group were significantly higher than those in the control group(P<0.05);The percentage of bone marrow plasma cells and serum LDH and CRP levels in the control group,MM stageⅠ,MM stageⅡand MM stageⅢpatients gradually increased(P<0.05);The serum LDH and CRP levels were higher in patients with primitive and naive plasma cell types than in mature plasma cell types,respectively(P<0.05);ROC curve analysis:the combination of bone marrow smear,serum LDH and CRP levels was the largest in diagnosing MM AUC(0.913),with good diagnostic efficacy and best sensitivity and specificity of 91.6%and 85.6%,respectively.Conclusion The combined diagnosis of MM with bone marrow smear,serum LDH and CRP levels is of greater value and helps to improve the sensitivity and accuracy of the diagnosis of this disease.