多发性骨髓瘤患者血清β2-MG、免疫球蛋白水平与预后的相关性分析

Correlation analysis between serumβ2-MG and immunoglobulin levels and prognosis in patients with multiple myeloma

目的分析多发性骨髓瘤患者血清β2-微球蛋白(β2-microglobulin, β2-MG)、免疫球蛋白水平与预后的相关性。方法选取秦皇岛市工人医院在2020年1月至2022年1月行硼替佐米、异环磷酰胺联合地塞米松(VCD)方案化疗治疗4个周期的80例多发性骨髓瘤患者纳入研究, 并进行随访, 将其分为预后良好组及预后不良组。比较不同预后患者血清β2-MG、免疫球蛋白G(immunoglobulin, Ig)G、IgA水平, Logistic回归分析多发性骨髓瘤的危险因素, 通过受试者工作特征曲线评估血清β2-MG、IgG、IgA水平预测多发性骨髓瘤的价值。结果预后不良组患者血清β2-MG、IgG、IgA水平明显高于预后良好组, 差异有统计学意义[(3.97±0.62)μg/L比(5.79±1.51)μg/L, (29.46±2.65)g/L比(35.21±3.46)g/L, (14.47±2.45)g/L比(20.38±2.61)g/L, t值分别为6.92, 8.29, 10.52, P值均<0.05]。经多因素Logistic回归分析, 证实血清β2-MG>5.23 μg/L、IgG>34.23 g/L、IgA>18.83 g/L是多发性骨髓瘤的危险因素(P<0.05);经过受试者工作特征曲线分析证实, 血清β2-MG、IgG、IgA水平可用于评估多发性骨髓瘤, 曲线下面积分别为0.88、0.91、0.96。结论β2-MG、IgG、IgA在多发性骨髓瘤患者血清中呈高表达, 检测其水平对多发性骨髓瘤患者病情评价及预后评估有潜在参考价值。

Objective To analyze the correlation between serumβ2-microglobulin(β2-MG)and immunoglobulin levels and prognosis in patients with multiple myeloma.Methods From January 2020 to January 2022,total of 80 patients with multiple myeloma who received bortezomib,ifosfamide combined with dexamethasone(VCD)chemotherapy for at least 4 cycles in our hospital were included in the study and followed up,and they were divided into a good prognosis group and a poor prognosis group.The levels of serumβ2-MG,immunoglobulin(Ig)G and IgA in patients with different prognosis were compared,and the risk factors of multiple myeloma were analyzed by Logistic regression.The value of serumβ2-MG,IgG and IgA levels in predicting multiple myeloma was evaluated by ROC.Results The serum levels ofβ2-MG,IgG and IgA in patients with poor prognosis were significantly higher than those in patients with good prognosis[(3.97±0.62)μg/L vs(5.79±1.51)μg/L,(29.46±2.65)g/L vs(35.21±3.46)g/L,(14.47±2.45)g/L vs(20.38±2.61)g/L,t values were 6.92,8.29,10.52,all P values<0.05].By multivariate Logistic regression analysis,serumβ2-MG>5.23μg/L、IgG>34.23 g/L、IgA>18.83 g/L were risk factors for multiple myeloma(P<0.05);receiver operating characteristic(ROC)analysis confirmed that serumβ2-MG,IgG and IgA levels could be used to evaluate multiple myeloma,and the areas under the curve were 0.88,0.91 and 0.96,respectively.Conclusion β2-MG,IgG and IgA are highly expressed in the serum of patients with multiple myeloma,and detecting the levels has potential reference value for the disease evaluation and prognosis evaluation of patients with multiple myeloma.