基于炎症指数的评分系统作为初诊多发性骨髓瘤患者预后标志的研究

石巧梅; 朱宏; 齐铭; 葛娇; 陆炎炎; 尹玲玲; 刘宁洒; 李玉陶; 李护君; 徐开林; 李振宇

doi:10.13201/j.issn.1004-2806.2021.07.003

基于炎症指数的评分系统作为初诊多发性骨髓瘤患者预后标志的研究

- 徐州医科大学附属医院血液科(江苏徐州, 221002)
基金项目:
江苏省医学重点人才项目(No:ZDRCA2016052)

详细信息

通讯作者: 李振宇,E-mail:lizhenyumd@163.com

中图分类号: R733.3

收稿日期: 2021-01-20

The study of inflammatory index based on scoring system as a prognostic marker for newly diagnosed multiple myeloma

- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China

More Information

Corresponding author: LI Zhenyu, E-mail: lizhenyumd@163.com

Received Date: 20 January 2021

摘要

摘要: 目的:研究由红细胞分布宽度(RDW)、中性粒细胞淋巴细胞比值(NLR)、血小板计数(PLT)三个指标组成的炎症预后评分系统(IPSI)作为初诊多发性骨髓瘤(MM)患者预后判断价值。方法:回顾性分析2014年1月—2019年4月在徐州医科大学附属医院血液科收治的180例初诊MM患者的临床指标,研究相关炎症标志物对生存的预后价值。IPSI包含的RDW、NLR、PLT的截止值由参考文献获得。并将高RDW(RDW>14%)、高NLR(NLR>2)或低PLT(PLT≤150×10⁹/L)评分各1分。根据所得评分形成IPSI,将患者分为低危组(0分)、中危组(1分)和高危组(2~3分)。结果:不同IPSI组间的无进展生存期(PFS)及总生存期(OS)差异均有统计学意义(均P<0.001)。多因素分析显示,IPSI是PFS(中危组HR 2.338,95%CI 1.235~4.428,高危组HR 4.048,95%CI 2.154~7.606,P<0.001)及OS(中危组HR 3.349,95%CI 1.163~9.646,高危组HR 8.410,95%CI 3.021~23.412,P<0.001)的独立预后因素。重要的是,IPSI可作为国际分期系统(ISS)的补充,IPSI亚组间的OS差异有统计学意义(ISSⅠ期,P=0.001;ISSⅡ期,P=0.008;ISSⅢ期,P=0.008)。结论:由RDW、NLR、PLT组成的IPSI可作为有效预测初诊MM患者预后判断标志物,并可作为ISS分期的有益补充。
- 多发性骨髓瘤 /
- 红细胞分布宽度 /
- 中性粒细胞与淋巴细胞比值 /
- 血小板计数 /
- 预后
Abstract: Objective: To study the prognostic value of inflammatory prognosis scoring system(IPSI) composed of red blood cell distribution width(RDW), neutrophil lymphocyte ratio(NLR) and platelet count(PLT) in newly diagnosed multiple myeloma(NDMM) patients.Methods: The clinical data of 180 NDMM patients in the Department of Hematology, Affiliated Hospital of Xuzhou Medical University from January 2014 to April 2019 were retrospectively analyzed, and the prognostic value of related inflammatory markers for survival was studied. The cut-off values of RDW, NLR and PLT included in IPSI were obtained from references. High RDW(RDW>14%), high NLR(NLR>2) or low PLT(PLT≤150×10⁹/L) were scored 1 point respectively. The patients were divided into low-risk group(0 point), medium-risk group(1 point) and high-risk group(2-3 points).Results: There were significant differences in progression-free survival(PFS) and overall survival(OS) between different IPSI groups(P<0.001). Multivariate analysis showed that IPSI was an independent prognostic factor for PFS(medium-risk group HR 2.338, 95%CI 1.235-4.428, high-risk group HR 4.048, 95%CI 2.154-7.606, P<0.001) and OS(medium-risk group HR 3.349, 95%CI 1.163-9.646, high-risk group HR 8.410, 95%CI 3.021-23.412, P<0.001). Importantly, IPSI can be used as a supplement to the international staging system(ISS), and there were significant differences in OS between IPSI subgroups(ISS stageⅠ, P=0.001; ISS stageⅡ, P=0.008; ISS stage Ⅲ, P=0.008).Conclusion: IPSI composed of RDW, NLR and PLT can be used as an effective prognostic marker for NDMM patients.
- multiple myeloma /
- red blood cell distribution width /
- neutrophil to lymphocyte ratio /
- platelet count /
- prognosis

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