摘要
目的探讨血清外周血淋巴/单核细胞比值(lymphocyte/monocyte ratio,LMR)预测多发性骨髓瘤化疗联合免疫调节剂治疗效果的价值。方法选取行化疗联合免疫调节剂治疗的93例多发性骨髓瘤患者为观察组,并选取91例同期健康体检者为对照组,检测并分析2组外周血淋巴细胞(absolute lymphocyte count,ALC)、单核细胞(absolute monocyte count,AMC)水平变化,计算血清LMR,分析血清LMR与多发性骨髓瘤化疗联合免疫调节剂治疗预后的相关性,并采用受试者工作特征曲线(ROC)、曲线下面积(AUC)及Z检验评价分析血清LMR对多发性骨髓瘤化疗联合免疫调节剂治疗后预后的预测价值。结果治疗后,观察组血清ALC、AMC、LMR水平均明显高于治疗前,且治疗前与治疗后观察组血清LMR水平明显低于对照组,差异存在统计学意义(P<0.05)。观察组经治疗后完全缓解42例、部分缓解27例、轻微缓解18例、无效6例,完全缓解组血清ALC、AMC、LMR水平最高,其次为部分缓解组和轻微缓解组,无效组最低,差异存在统计学意义(P<0.05)。血清ALC、AMC、LMR水平与多发性骨髓瘤化疗联合免疫调节剂治疗后疗效均呈正相关(P<0.05);ROC曲线分析得出,血清LMR水平预测多发性骨髓瘤患者治疗后预后的AUC为0.750,灵敏度为74.7%,特异度为68.8%,95%置信区间为0.678~0.822。结论血清LMR在对多发性骨髓瘤化疗联合免疫调节剂治疗效果的预测中具有重要价值。
Objective To investigate the value of serum lymphocyte/monocyte ratio(LMR)in predicating prognosis in patients with multiple myeloma treated with chemotherapy combined with immunomodulators.Methods 93 patients with multiple myeloma who underwent chemotherapy combined with immunomodulators were selected as the observation group,and 91 healthy subjects in the same period were selected as the control group.The changes of peripheral blood lymphocytes(ALC)and monocytes(AMC)levels in the 2 groups were detected and analyzed.The serum LMR was calculated.The correlation between serum LMR and the prognosis of multiple myeloma treated with chemotherapy combined with immunomodulators was analyzed.The predictable value of serum LMR for multiple myeloma treated with chemotherapy combined with immunomodulators was evaluated and analyzed using receiver operating characteristic curve(ROC),area under the curve(AUG)and Z test.Results After treatment,the levels of serum ALC,AMC and LMR in the observation group were significantly higher than those before treatment,and the levels of serum LMR in the observation group before and after treatment were significantly lower than those in the control group(P<0.05);In the observation group,42 cases were in complete remission,27 cases were in partial remission,18 cases were in slight remission and 6 cases were ineffective after treatment.The serum ALC,AMC and LMR levels in the complete remission group were the highest,followed by the partial remission group and slight remission group,and the serum ALC,AMC and LMR levels in the ineffective group were the lowest.There was significant difference(P<0.05).The levels of serum ALC,AMC and LMR were positively correlated with the efficacy of chemotherapy combined with immunomodulator in the treatment of multiple myeloma(P<0.05).ROC curve analysis showed that the AUC of serum LMR level in predicting the prognosis of multiple myeloma patients after treatment was 0.750,the sensitivity was 74.7%,the specificity was 68.8%,and the 95%confidence interval was 0.678-0.822.Conclusion Serum LMR is of great value in predicting the prognosis of patients with multiple myeloma treated with chemotherapy combined with immunomodulators.
作者
张俊霞
段鹏月
杨丽鸽
ZHANG Junxia;DUAN Pengyue;YANG Lige(Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou,450000)
出处
《实用癌症杂志》
2023年第7期1058-1061,1065,共5页
The Practical Journal of Cancer
