血清CAR LMR T淋巴细胞亚群与多发性骨髓瘤患者预后的相关性分析

doi:10.3969/j.issn.1006-6233.2024.02.011

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摘要 目的: 探讨血清C反应蛋白与白蛋白比值(CAR)、淋巴细胞/单核细胞比值(LMR)、T淋巴细胞亚群与多发性骨髓瘤(MM)患者预后的相关性。方法: 选取2020年1月至2022年1月诊治的105例多发性骨髓瘤患者作为研究对象,设立为观察组,同期选取75例健康体检者设立为对照组。根据MM患者治疗后随访2年是否出现复发或死亡分为预后不良组(n=34)和预后良好组(n=71),对比血清CAR、LMR、T淋巴细胞亚群(CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺)。采用Logistic回归分析CAR、LMR、CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺对MM患者预后的影响。采用ROC曲线模型分析CAR、LMR、CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺、T淋巴细胞亚群综合参数预测MM患者预后的AUC值、敏感度和特异度。结果: 观察组的CAR、CD8⁺高于对照组,而LMR、CD3⁺、CD4⁺、CD4⁺/CD8⁺低于对照组(P<0.05)。预后不良组的CAR、CD8⁺高于预后良好组,而LMR、CD3⁺、CD4⁺、CD4⁺/CD8⁺低于预后良好组(P<0.05)。二元Logistic回归分析显示,CAR、CD8⁺升高和LMR、CD3⁺、CD4⁺、CD4⁺/CD8⁺下降会对MM患者预后产生影响(P<0.05)。ROC曲线分析显示,CAR、LMR、CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺、T淋巴细胞亚群综合参数预测MM患者预后的AUC值分别为(0.637、0.792、0.726、0.767、0.669、0.750、0.853,P<0.05)。结论: 血清CAR、LMR、T淋巴细胞亚群在MM患者中呈异常表达趋势,检测其变化有利于为评估MM患者的预后提供重要参考。

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关键词 ： C反应蛋白与白蛋白比值, 淋巴细胞/单核细胞比值, T淋巴细胞亚群, 多发性骨髓瘤, 预后

Abstract：Objective: To investigate the association of serum C-reactive protein to albumin ratio (CAR), lymphocyte to monocyte ratio (LMR), and T lymphocyte subsets with the prognosis of multiple myeloma (MM) patients. Methods: A total of 105 patients with multiple myeloma diagnosed and treated from January 2020 to January 2022 were selected as the study objects and set as the observation group. A total of 75 healthy controls were enrolled as the control group. MM patients were divided into poor prognosis group (n=34) and good prognosis group (n=71) according to whether recurrence or death occurred within 2 years of follow-up after treatment. Serum CAR, LMR, and T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺) were compared. Logistic regression analysis was used to analyze the effects of CAR, LMR, CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺ on the prognosis of MM patients. ROC curve analysis was used to analyze the AUC values, sensitivity, and specificity of CAR, LMR, CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺ and T lymphocyte subsets to predict the prognosis of MM patients. Results: The CAR and CD8⁺ levels were significantly higher, while the LMR, CD3⁺, CD4⁺, and CD4⁺/CD8⁺ levels were significantly lower in the observation group than in the control group (P<0.05). The CAR and CD8⁺ levels were significantly higher, while the LMR, CD3⁺, CD4⁺, and CD4⁺/CD8⁺ levels were significantly lower in the poor prognosis group than in the good prognosis group (P<0.05). Binary Logistic regression model analysis showed that the increase of CAR and CD8⁺ and the decrease of LMR, CD3⁺, CD4⁺, CD4⁺/CD8⁺ would affect the prognosis of MM patients (P<0.05). ROC curve analysis showed that the combined parameters of CAR, LMR, CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺ and T lymphocyte subsets predicted the prognosis of MM patients with AUC values of 0.637, 0.792, 0.726, 0.767, 0.669, 0.750, 0.853, respectively (P<0.05). Conclusion: Serum CAR, LMR, and T lymphocyte subsets showed abnormal expression trends in MM patients. The detection of their changes is helpful for providing important reference for the assessment of the prognosis of MM patients.

Key words： C-reactive protein to albumin ratio Lymphocyte/Monocyte ratio T lymphocyte subpopulations Multiple myeloma Prognosis

基金资助:山西省自然科学基金计划项目,(编号:2021015042)

引用本文:

达海丽, 张旭光, 田卫伟, 解菊芬. 血清CAR LMR T淋巴细胞亚群与多发性骨髓瘤患者预后的相关性分析[J]. 河北医学, 2024, 30(2): 234-238.
DA Haili, ZHANG Xuguang, et al. Association of Serum CAR LMR and T Lymphocyte Subsets with Prognosis of Multiple Myeloma Patients. HeBei Med, 2024, 30(2): 234-238.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.02.011 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I2/234