胱抑素C和β2微球蛋白在多发性骨髓瘤病情及近期疗效评价中的应用

Yunyu Zhang, Jing Peng, Zhigang Song, Xing-jing Li
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The differences of Cys-C and β2-MG levels between the patients with different short-term efficacy were compared. The receiver operating characteristic (ROC) curve was used to analyze the value of the two indicators in the evaluation of MM efficacy, and the correlation between Cys-C and β2-GM was analyzed. Logistic regression analysis was used to analyze the multiple factors affecting the clinical efficacy of MM patients. \n \n \nResults \nThe levels of Cys-C and β2-MG in the serum of the patients with MM were (2.11±0.78) mg/L and (6.07±3.08) g/L respectively, and those in the control group were (0.75±0.20) mg/L and (1.78±0.59) g/L, with significant differences (t=33.848, P<0.001; t=28.084, P<0.001). The Cys-C levels of Durie-Salmon stage Ⅰ, Ⅱ and Ⅲ patients were (0.99±0.21) mg/L, (1.36±0.17) mg/L and (3.07±1.02) mg/L respectively, and the difference was statistically significant (F=44.157, P<0.001). The β2-MG levels in the serum of patients with stage Ⅰ, Ⅱ and Ⅲ were (2.57±0.75) g/L, (4.66±1.43) g/L, (8.63±2.26) g/L respectively, and the difference was statistically significant (F=57.285, P<0.001). In all the patients, 338 patients were effective, accoun-ting for 75.11%, and 112 patients were ineffective, accounting for 24.89%. The levels of Cys-C and β2-MG in the serum of the effective MM patients were (1.28±0.23) mg/L and (2.82±0.78) g/L, and those of ineffective patients were (2.97±0.77) mg/L and (6.22±1.92) g/L, with statistically significant differences (t=35.874, P<0.001; t=26.633, P<0.001). The sensitivity of serum Cys-C for predicting short-term efficacy was 83.0%, the specificity was 76.6%, and those of serum β2-MG were 89.3% and 73.6%. The area under curve (AUC) of the serum Cys-C was 0.813 (95%CI: 0.764-0.862), and the AUC of serum β2-MG was 0.865 (95%CI: 0.825-0.906), with a statistically significant difference (Z=2.490, P=0.011). Spearman correlation analysis showed a positive correlation between serum Cys-C and β2-MG (r=0.539, P=0.041). Logistic regression analysis showed that both β2-MG (95%CI: 2.386-5.144, P<0.001) and Cys-C (95%CI: 2.367-9.702, P<0.001) were independent factors affecting the short-term efficacy of MM. Multivariate analysis showed that β2-MG (95%CI: 3.549-13.739, P=0.001) was an independent factor affecting the efficacy of MM. \n \n \nConclusion \nThe levels of serum Cys-C and β2-M in MM patients are significantly higher than those in healthy people, and they show an increasing trend with the progression of MM disease, which can be used as markers for the pathological staging diagnosis of MM patients. The short-term efficacy of the patients can be evaluated by using the two indicators, and the clinical significance in efficacy evaluation of β2-MG is slightly better than that of Cys-C. \n \n \nKey words: \nMultiple myeloma; Diagnosis; Treatment outcome; Cystatin-C; β2-microglobulin","PeriodicalId":16120,"journal":{"name":"国际肿瘤学杂志","volume":"42 1","pages":"590-594"},"PeriodicalIF":0.0000,"publicationDate":"2019-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Application of cystatin C and β2-microglobulin in the assessment of condition and short-term efficacy of multiple myeloma\",\"authors\":\"Yunyu Zhang, Jing Peng, Zhigang Song, Xing-jing Li\",\"doi\":\"10.3760/CMA.J.ISSN.1673-422X.2019.10.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective \\nTo explore the application value of serum cystatin C (Cys-C) and β2-microglobulin (β2-MG) in the diagnosis and short-term efficacy evaluation of multiple myeloma (MM). \\n \\n \\nMethods \\nA total of 450 patients with MM admitted to Anqing Hospital of Chinese People′s Liberation Army Navy and Jinhua Central Hospital of Zhejiang Province from October 2016 to October 2018 were selected as subjects (MM group), according to the Durie-Salmon staging criteria, including 150 patients in stage Ⅰ, Ⅱ and Ⅲ. A total of 150 healthy subjects were selected as the control group. The levels of Cys-C and β2-MG in the serum of the subjects were determined. The differences of Cys-C and β2-MG levels between the two groups and the MM patients with different Durie-Salmon stages were compared. The differences of Cys-C and β2-MG levels between the patients with different short-term efficacy were compared. The receiver operating characteristic (ROC) curve was used to analyze the value of the two indicators in the evaluation of MM efficacy, and the correlation between Cys-C and β2-GM was analyzed. Logistic regression analysis was used to analyze the multiple factors affecting the clinical efficacy of MM patients. \\n \\n \\nResults \\nThe levels of Cys-C and β2-MG in the serum of the patients with MM were (2.11±0.78) mg/L and (6.07±3.08) g/L respectively, and those in the control group were (0.75±0.20) mg/L and (1.78±0.59) g/L, with significant differences (t=33.848, P<0.001; t=28.084, P<0.001). 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引用次数: 0

摘要

目的探讨血清胱抑素C (Cys-C)和β2-微球蛋白(β2-MG)在多发性骨髓瘤(MM)诊断及近期疗效评价中的应用价值。方法选择2016年10月~ 2018年10月在中国人民解放军海军安庆医院和浙江省金华市中心医院住院的MM患者450例作为研究对象(MM组),按照Durie-Salmon分期标准,其中Ⅰ、Ⅱ、Ⅲ期患者150例。选取150名健康受试者作为对照组。测定受试者血清中Cys-C和β2-MG的水平。比较两组及不同期期MM患者血清Cys-C、β2-MG水平的差异。比较不同短期疗效患者血清Cys-C、β2-MG水平的差异。采用受试者工作特征(ROC)曲线分析两项指标在MM疗效评价中的价值,并分析Cys-C与β2-GM的相关性。采用Logistic回归分析对影响MM患者临床疗效的多因素进行分析。结果MM患者血清Cys-C和β2-MG水平分别为(2.11±0.78)mg/L和(6.07±3.08)g/L,对照组血清Cys-C和β2-MG水平分别为(0.75±0.20)mg/L和(1.78±0.59)g/L,差异有统计学意义(t=33.848, P<0.001;t = 28.084, P < 0.001)。durrie - salmon期Ⅰ、Ⅱ、Ⅲ患者Cys-C水平分别为(0.99±0.21)mg/L、(1.36±0.17)mg/L、(3.07±1.02)mg/L,差异有统计学意义(F=44.157, P<0.001)。Ⅰ、Ⅱ、Ⅲ期患者血清β2-MG水平分别为(2.57±0.75)g/L、(4.66±1.43)g/L、(8.63±2.26)g/L,差异有统计学意义(F=57.285, P<0.001)。所有患者中有效338例,占75.11%,无效112例,占24.89%。MM有效组血清Cys-C和β2-MG水平分别为(1.28±0.23)mg/L和(2.82±0.78)g/L,无效组血清Cys-C和β2-MG水平分别为(2.97±0.77)mg/L和(6.22±1.92)g/L,差异均有统计学意义(t=35.874, P<0.001;t = 26.633, P < 0.001)。血清Cys-C预测短期疗效的敏感性为83.0%,特异性为76.6%,血清β2-MG预测短期疗效的敏感性为89.3%,特异性为73.6%。血清Cys-C曲线下面积(AUC)为0.813 (95%CI: 0.764 ~ 0.862),血清β2-MG曲线下面积(AUC)为0.865 (95%CI: 0.825 ~ 0.906),差异有统计学意义(Z=2.490, P=0.011)。Spearman相关分析显示血清Cys-C与β2-MG呈正相关(r=0.539, P=0.041)。Logistic回归分析显示,β2-MG (95%CI: 2.386 ~ 5.144, P<0.001)和Cys-C (95%CI: 2.367 ~ 9.702, P<0.001)是影响MM短期疗效的独立因素。结论MM患者血清Cys-C、β2-M水平明显高于健康人群,且随MM疾病进展呈升高趋势,可作为MM患者病理分期诊断的标志。两项指标均可评价患者的短期疗效,其中β2-MG疗效评价的临床意义略优于Cys-C。关键词:多发性骨髓瘤;诊断;治疗效果;半胱氨酸蛋白酶抑制物c;β2-microglobulin
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Application of cystatin C and β2-microglobulin in the assessment of condition and short-term efficacy of multiple myeloma
Objective To explore the application value of serum cystatin C (Cys-C) and β2-microglobulin (β2-MG) in the diagnosis and short-term efficacy evaluation of multiple myeloma (MM). Methods A total of 450 patients with MM admitted to Anqing Hospital of Chinese People′s Liberation Army Navy and Jinhua Central Hospital of Zhejiang Province from October 2016 to October 2018 were selected as subjects (MM group), according to the Durie-Salmon staging criteria, including 150 patients in stage Ⅰ, Ⅱ and Ⅲ. A total of 150 healthy subjects were selected as the control group. The levels of Cys-C and β2-MG in the serum of the subjects were determined. The differences of Cys-C and β2-MG levels between the two groups and the MM patients with different Durie-Salmon stages were compared. The differences of Cys-C and β2-MG levels between the patients with different short-term efficacy were compared. The receiver operating characteristic (ROC) curve was used to analyze the value of the two indicators in the evaluation of MM efficacy, and the correlation between Cys-C and β2-GM was analyzed. Logistic regression analysis was used to analyze the multiple factors affecting the clinical efficacy of MM patients. Results The levels of Cys-C and β2-MG in the serum of the patients with MM were (2.11±0.78) mg/L and (6.07±3.08) g/L respectively, and those in the control group were (0.75±0.20) mg/L and (1.78±0.59) g/L, with significant differences (t=33.848, P<0.001; t=28.084, P<0.001). The Cys-C levels of Durie-Salmon stage Ⅰ, Ⅱ and Ⅲ patients were (0.99±0.21) mg/L, (1.36±0.17) mg/L and (3.07±1.02) mg/L respectively, and the difference was statistically significant (F=44.157, P<0.001). The β2-MG levels in the serum of patients with stage Ⅰ, Ⅱ and Ⅲ were (2.57±0.75) g/L, (4.66±1.43) g/L, (8.63±2.26) g/L respectively, and the difference was statistically significant (F=57.285, P<0.001). In all the patients, 338 patients were effective, accoun-ting for 75.11%, and 112 patients were ineffective, accounting for 24.89%. The levels of Cys-C and β2-MG in the serum of the effective MM patients were (1.28±0.23) mg/L and (2.82±0.78) g/L, and those of ineffective patients were (2.97±0.77) mg/L and (6.22±1.92) g/L, with statistically significant differences (t=35.874, P<0.001; t=26.633, P<0.001). The sensitivity of serum Cys-C for predicting short-term efficacy was 83.0%, the specificity was 76.6%, and those of serum β2-MG were 89.3% and 73.6%. The area under curve (AUC) of the serum Cys-C was 0.813 (95%CI: 0.764-0.862), and the AUC of serum β2-MG was 0.865 (95%CI: 0.825-0.906), with a statistically significant difference (Z=2.490, P=0.011). Spearman correlation analysis showed a positive correlation between serum Cys-C and β2-MG (r=0.539, P=0.041). Logistic regression analysis showed that both β2-MG (95%CI: 2.386-5.144, P<0.001) and Cys-C (95%CI: 2.367-9.702, P<0.001) were independent factors affecting the short-term efficacy of MM. Multivariate analysis showed that β2-MG (95%CI: 3.549-13.739, P=0.001) was an independent factor affecting the efficacy of MM. Conclusion The levels of serum Cys-C and β2-M in MM patients are significantly higher than those in healthy people, and they show an increasing trend with the progression of MM disease, which can be used as markers for the pathological staging diagnosis of MM patients. The short-term efficacy of the patients can be evaluated by using the two indicators, and the clinical significance in efficacy evaluation of β2-MG is slightly better than that of Cys-C. Key words: Multiple myeloma; Diagnosis; Treatment outcome; Cystatin-C; β2-microglobulin
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