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摘要: 目的 探讨羧酸酯酶2(carboxylesterase 2，CES2)在多发性骨髓瘤(multiple myeloma，MM)中的临床意义。方法 对2020至2021年确诊为MM患者69例，采用酶联免疫吸附试验测定检测治疗前及化疗后2周后血清CES2含量，与60例正常体检人群进行比较。同时比较不同分期、分型患者血清CES2差异。通过医院信息系统、实验室信息系统、输血信息管理系统收集患者基本资料、主要实验室检查结果及成分输血情况，分析CES2与MM疾病进程的相关性。结果 69例MM患者治疗前血清CES2平均含量为(24.35±5.98) ng/mL，明显高于正常对照的(5.69±1.62) ng/mL(P < 0.05)，治疗后为(15.68±3.83) ng/mL，较治疗前明显下降(P < 0.05)。Ⅲ期患者CES2明显高于Ⅰ、Ⅱ期患者(P < 0.05)，不同分型间差异无统计学意义(P>0.05)。治疗前血清CES2含量与患者血清肌酐、β-2微球蛋白及乳酸脱氢酶呈正相关(P < 0.05)，治疗前血清CES2含量与患者血红蛋白、白蛋白呈负相关(P < 0.05)，病程中输注红细胞患者的治疗前血清CES2含量明显高于未输注红细胞患者(P < 0.05)。结论 CES2对MM的疾病进程预测具有临床价值。Abstract: Objective To investigate the clinical significance of carboxylesterase 2(CES2) in multiple myeloma(MM).Methods Enzyme-linked immunosorbent assay(ELISA) was used to measure serum CES2 content before treatment and 2 weeks after chemotherapy in 69 patients with MM diagnosed in our hospital from 2020 to 2021, and the difference was compared with the normal population. The difference of serum carboxylesterase 2 in patients with different stages and types was compared. Patients' basic information, major laboratory test results and component blood transfusion were collected through HIS, LIS and blood transfusion information management system to analyze the correlation between carboxylesterase 2 and the progression of multiple myeloma disease.Results The average content of serum CES2 in 69 MM patients before treatment was(24.35±5.98) ng/mL, which was higher than that in normal control(5.69±1.62) ng/mL(P < 0.05), and after treatment was(15.68±3.83) ng/mL, which was significantly lower than that before treatment(P < 0.05). The CES2 in stage Ⅲ patients was higher than those in stage Ⅰ and Ⅱ patients(P < 0.05), and no significant difference was found among different types(P>0.05). Serum CES2 content was positively correlated with serum creatinine and β-2 microglobulin before treatment(P < 0.05), and serum CES2 content was negatively correlated with hemoglobin and albumin of patients before treatment(P < 0.05). Serum CES2 content in the patients receiving red blood cell infusion during the course of disease was higher than that in the patients without red blood cell infusion(P < 0.05).Conclusion CES2 had clinical value in predicting the disease course of MM.
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Key words:
- carboxylesterase 2 /
- multiple myeloma /
- transfusion
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表 1 MM患者血清CES2水平与对照组比较
ng/mL，X±S 组别 例数 治疗前 治疗后 MM组 69 24.35±5.981) 15.68±3.831)2) 对照组 60 5.69±1.62 - 与对照组比较，1) P < 0.05；与治疗前比较，2)P < 0.05。 
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表 2 不同分期、分型MM患者治疗前后血清CES2水平比较
ng/mL，X±S 分期/分型 例数 治疗前 治疗后 ISS分期 Ⅰ 18 18.89±4.98 14.29±2.132) Ⅱ 19 19.33±3.44 13.68±4.262) Ⅲ 32 30.14±5.321) 17.42±3.172) M蛋白分型 IgG 30 22.90±4.89 16.29±4.122) IgA 19 29.78±5.68 15.58±4.332) 轻链型 17 23.63±3.16 13.29±5.672) IgD 3 25.89±5.12 16.33±5.122) 与Ⅰ、Ⅱ期比较，1)P < 0.05；与治疗前比较，2)P < 0.05。
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表 3 MM患者血清CES2水平与主要实验室检测指标相关性分析
X±S 检测指标 数值 r P 尿素/(mmol/L) 8.70±2.53 0.298 0.062 肌酐/(μmmol/L) 153.72±21.49 0.412 0.019 β-2微球蛋白/(mg/L) 6.78±3.14 0.396 0.032 血红蛋白/(g/L) 72.30±8.70 -0.310 0.028 血小板/(×109/L) 152.00±16.60 -0.166 0.899 白蛋白/(g/L) 30.30±5.40 -0.482 0.021 球蛋白/(g/L) 62.60±8.80 0.267 0.686 乳酸脱氢酶 333.40±54.80 0.441 0.037 血沉/(mm/h) 117.34±33.41 0.142 0.398 血清钙/(mmol/L) 2.10±0.30 0.203 0.162 C反应蛋白/(mg/L) 11.66±0.77 0.189 0.221
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表 4 MM患者血清CES2水平与成分输血情况分析
输血情况 例数 输红细胞/U 治疗前/(ng/mL) 输红细胞 19 1.67±0.61 30.82±6.571) 未输红细胞 50 - 21.94±5.48 与未输红细胞比较，1) P < 0.05。
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| 引用本文: |
李莺, 朱雯雯, 陈瑞妮. 羧酸酯酶2对多发性骨髓瘤的临床意义探讨[J]. 临床血液学杂志, 2023, 36(6): 406-408. doi: 10.13201/j.issn.1004-2806.2023.06.005
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| Citation: |
LI Ying, ZHU Wenwen, CHEN Ruini. Clinical significance of carboxylesterase 2 in multiple myeloma[J]. J Clin Hematol, 2023, 36(6): 406-408. doi: 10.13201/j.issn.1004-2806.2023.06.005
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