多指标联合检测对多发性骨髓瘤早期肾损伤患者的诊断及预后评估价值

doi:10.3969/j.issn.1004-616x.2025.05.007

癌变·畸变·突变 ›› 2025, Vol. 37 ›› Issue (5): 389-392,399.doi: 10.3969/j.issn.1004-616x.2025.05.007

• 论著 • 上一篇

多指标联合检测对多发性骨髓瘤早期肾损伤患者的诊断及预后评估价值

杜彦艳¹, 李洁¹, 周文烨¹, 马鸣¹, 崔雯瑄¹, 王振达¹, 姚影珍²

1. 河北医科大学第四医院检验科, 河北石家庄 050011;
2. 河北医科大学第四医院血液内科, 河北石家庄 050011

收稿日期:2025-03-20 修回日期:2025-08-27 发布日期:2025-10-17
通讯作者: 姚影珍
作者简介:杜彦艳，E-mail：duyanyan9868@163.com。
基金资助:
河北省卫生健康委员会重点课题项目(20200093);河北省 2023政府资助临床医学优秀人才培养项目(ZF2023043)

Diagnostic and prognostic values of multi-biomarker detection in patients with early renal damage due to multiple myeloma

DU Yanyan¹, LI Jie¹, ZHOU Wenye¹, MA Ming¹, CUI Wenxuan¹, WANG Zhenda¹, YAO Yingzhen²

1. Department of Clinical Laboratory, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011;
2. Department of Hematology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei, China

Received:2025-03-20 Revised:2025-08-27 Published:2025-10-17

摘要/Abstract

摘要： 目的：探讨实验室多指标联合检测在多发性骨髓瘤(MM)患者早期肾损伤诊断及预后评估中的应用价值。 方法：选取2018年11月—2023年5月河北医科大学第四医院血液内科收治的95例初诊MM患者作为研究对象，根据血肌酐(SCr)水平将患者分为非肾损伤组(71例)与肾损伤组(24例)，并收集其临床病理资料及血常规、凝血功能、生化等相关实验室检测指标。另选取30例无良恶性肿瘤、心血管等疾病的健康志愿者作为对照组。比较各组患者各指标的差异，绘制ROC曲线评价中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)、全身性炎症反应指数(SIRI)和血浆纤维蛋白原/血清白蛋白比值(FAR)对MM患者发生肾损伤的预测价值，并分析其与MM患者分期及瘤负荷的相关性。 结果：MM患者合并肾损伤组NLR、MLR、SIRI和FAR等指标的水平明显高于对照组和MM患者非肾损伤组(P<0.05)；ROC曲线显示其对MM患者发生肾损伤具有预测价值(P<0.05)，4个指标联合检测对MM患者合并肾损伤辅助诊断应用价值更高；通过logistic回归分析发现NLR、MLR、SIRI和FAR均与MM患者是否发生肾损伤密切相关。其中，NLR升高是MM患者发生肾损伤的独立危险因素。卡方检验结果显示，MLR与MM患者ISS分期密切相关(P<0.05)。 结论：NLR、MLR、SIRI、FAR与MM患者肾损伤的临床进展密切相关，四者联合检测可预测MM患者发生肾损伤的临床进展，将炎症指标作为辅助指标应用于MM合并肾损伤的临床诊疗具有重要价值。

关键词: 多发性骨髓瘤肾损伤, 肿瘤标志物, 中性粒细胞/淋巴细胞比值, 单核细胞/淋巴细胞比值, 炎症指标

Abstract: OBJECTIVE：To investigate diagnostic and prognostic values of multi-biomarker detection in patients with early renal damage due to multiple myeloma (MM). METHODS：From November 2018 to May 2023，newly diagnosed MM patients admitted to the Department of Hematology of the Fourth hospital of Hebei Medical University were recruited as study subjects. According to the blood creatinine (SCr) detection level， the patients were divided into two MM groups with or without kidney injury，and the clinicopathological data， blood routine， coagulation function， biochemistry and other related laboratory detection indicators were collected. In addition， 30 healthy volunteers without benign or malignant tumors nor cardiovascular diseases were selected as the control group. The ROC curve was drawn to evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR)， monocyte-to-lymphocyte ratio (MLR)， systemic inflammation response index (SIRI) and fibrinogen-to-albumin ratio (FAR) in the occurrence of kidney injury in MM patients，and the correlation with tumor stage and tumor load of MM patients was analyzed. RESULTS： From our recruitment， 95 patients and 30 controls were selected. The levels of NLR， MLR， SIRI and FAR in MM patients with kidney injury were significantly higher than those in control group and MM patients without kidney injury group (P<0.05). ROC curves showed that NLR，MLR，SIRI and FAR had predictive value in MM patients with kidney injury (P<0.05). Combined detection using the four biomarkers showed higher diagnostic values for the MM patients with kidney injury. Logistic regression analysis showed that the level of NLR， MLR， SIRI and FAR were closely related to the occurrence of kidney injury in MM patients. High NLR was an independent risk factor for kidney injury in MM patients. Chi-square test results showed that MLR was closely correlated with ISS stage in MM patients (P<0.05). CONCLUSION：NLR，MLR，SIRI and FAR showed value in the diagnosis of kidney injury in MM patients. Combined diagnosis improved the diagnostic efficiency，and provided a basis for the application of inflammatory markers in the clinical diagnosis and treatment of MM patients with kidney injury.

Key words: renal damage in multiple myeloma, tumor biomarker, NLR, MLR, inflammation indicators

中图分类号:

R446.1

杜彦艳, 李洁, 周文烨, 马鸣, 崔雯瑄, 王振达, 姚影珍. 多指标联合检测对多发性骨髓瘤早期肾损伤患者的诊断及预后评估价值[J]. 癌变·畸变·突变, 2025, 37(5): 389-392,399.

DU Yanyan, LI Jie, ZHOU Wenye, MA Ming, CUI Wenxuan, WANG Zhenda, YAO Yingzhen. Diagnostic and prognostic values of multi-biomarker detection in patients with early renal damage due to multiple myeloma[J]. Carcinogenesis, Teratogenesis & Mutagenesis, 2025, 37(5): 389-392,399.

参考文献

[1] DIMOPOULOS M A, MIKHAEL J, TERPOS E, et al. An overview of treatment options for patients with relapsed/ refractory multiple myeloma and renal impairment[J]. Ther Adv Hematol, 2022, 13: 20406207221088458.
[2] 陈楠. 重视多发性骨髓瘤肾损伤的诊断与治疗[J]. 中华内科杂志, 2017, 56(11): 795-797.
[3] DIMOPOULOS M A, MERLINI G, BRIDOUX F, et al. Management of multiple myeloma-related renal impairment: recommendations from the International Myeloma Working Group[J]. Lancet Oncol, 2023, 24(7): e293-e311.
[4] SHI H, CHEN Z J, XIE J Y, et al. The prevalence and management of multiple myeloma-induced kidney disease in China[J]. Kidney Dis, 2016, 1(4): 235-240.
[5] 唐娟,管保章.多发性骨髓瘤伴肾损伤的发病机制与治疗进展[J].现代临床医学, 2022, 48(1): 73-77.
[6] COURANT M, ORAZIO S, MONNEREAU A, et al. Incidence, prognostic impact and clinical outcomes of renal impairment in patients with multiple myeloma: a population-based registry[J]. Nephrol Dial Transplant, 2021, 36(3): 482-490.
[7] MOHYUDDIN G R, KOEHN K, SHUNE L, et al. Renal insufficiency in multiple myeloma: a systematic review and meta-analysis of all randomized trials from 2005-2019[J]. Leuk Lymphoma, 2021, 62(6): 1386-1395.
[8] 翟红,赵国江,邹兴立,等.纤维蛋白原与多发性骨髓瘤患者预后的关系[J].川北医学院学报, 2019, 34(3): 367-370.
[9] 杜晔,郭一丹,贾萌,等.多发性骨髓瘤合并急性肾损伤患者的临床特征及相关风险因素分析[J].临床肿瘤学杂志, 2023, 28(5): 415-419.
[10] BAGSHAW S M, GEORGE C, BELLOMO R. Early acute kidney injury and sepsis: a multicentre evaluation[J]. Crit Care, 2008, 12(2): R47.
[11] 王豪言,孙晓白,李梦一,等.多发性骨髓瘤患者首次治疗部分缓解时NLR、MLR与预后的关系[J].山东医药, 2023, 63(8): 1-5.
[12] HUA X, LONG Z Q, HUANG X, et al. The preoperative systemic inflammation response index (SIRI) independently predicts survival in postmenopausal women with breast cancer [J]. Curr Probl Cancer, 2020, 44(4): 100560.
[13] 张亚东,胡音音,杨启.外周血PLR、NLR检测对胃癌诊断与病程评估的价值[J].实用医药杂志,2020, 37(9): 811-813, 865.
[14] ZHANG G J, YANG C, ZHAO C X, et al. Prognostic value of the neutrophil-to-lymphocyte ratio in patients treated with definitive chemoradiotherapy for locally advanced oesophageal squamous cell carcinoma[J]. Cancer Manag Res, 2023, 15: 101-112.
[15] MO C J, HU Z J, QIN S Z, et al. Diagnostic value of platelet-lymphocyte ratio and hemoglobin-platelet ratio in patients with rectal cancer[J]. J Clin Lab Anal, 2020, 34(4): e23153.

多指标联合检测对多发性骨髓瘤早期肾损伤患者的诊断及预后评估价值

Diagnostic and prognostic values of multi-biomarker detection in patients with early renal damage due to multiple myeloma

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	童晶, 王丹. miR-544a在结直肠癌组织中的表达及其意义[J]. 癌变·畸变·突变, 2024, 36(2): 124-128,137.
[2]	李燕, 冯军花, 赵红峥, 张金艳, 满宏伟. 人血清半胱氨酸蛋白酶抑制剂S及肿瘤标志物在口腔颌面部恶性肿瘤中的诊断价值[J]. 癌变·畸变·突变, 2023, 35(3): 192-196.
[3]	秦景娜, 周英发, 刘贺勇. 炎症指标和肿瘤标记物联合检测对术前胃癌分期的诊断价值[J]. 癌变·畸变·突变, 2023, 35(2): 139-143.
[4]	余紫娟, 谈美娟, 余小红. 血管内皮生长因子和基质金属蛋白酶在恶性腹水形成及诊疗中的临床意义[J]. 癌变·畸变·突变, 2023, 35(2): 158-164.
[5]	刘霞, 高孜博, 丁丽华, 吴拥军. 肺癌患者血浆外泌体microRNAs标志物的筛选[J]. 癌变·畸变·突变, 2022, 34(6): 407-412.
[6]	焦文静, 郭秀娟, 邵俊国, 焦文鹏, 张金艳. 中性粒细胞和血小板与淋巴细胞比值对食管鳞癌临床病理特征及预后的意义[J]. 癌变·畸变·突变, 2021, 33(3): 213-217.
[7]	杜强, 姚义勇, 曾刚. 基于TCGA数据库分析ASPM在肺腺癌中的表达及临床意义[J]. 癌变·畸变·突变, 2020, 32(6): 457-463.
[8]	马鸣, 焦文静, 王延海, 颜晰, 张超, 张金艳. 弥漫大B细胞淋巴瘤患者血清IL-24及IL-6浓度检测的临床意义[J]. 癌变·畸变·突变, 2019, 31(3): 227-230.
[9]	崔宏伟, 苏秀兰. 胃癌干细胞在胃癌靶向治疗中的研究进展[J]. 癌变·畸变·突变, 2018, 30(6): 490-493.
[10]	龚瑜, 杨其昌, 袁荣华, 周峰, 李国利. 胃癌组织与血清miR-126的表达及临床意义[J]. 癌变·畸变·突变, 2017, 29(4): 272-276,283.
[11]	许镒洧, 郭竑, 郭海鹏, 彭裕辉. DKK1在食管胃结合部腺癌患者血清中的水平及其临床诊断价值[J]. 癌变·畸变·突变, 2017, 29(2): 139-142.
[12]	蓝宇, 刘东东, 林明恩, 洪英楷, 黄建生, 陈思, 何学军. 沉默信息调节因子1在膀胱尿路上皮细胞癌中的表达与意义[J]. 癌变·畸变·突变, 2015, 27(2): 125-128.
[13]	黄素英;黄昌明;田俊;陈华. 胃肠道恶性肿瘤患者血清AFP、CEA 和CA19-9的表达特征探讨[J]. , 2012, 24(5): 376-378.
[14]	孟　君, 刘丽华(综述), 单保恩(审校). 蛋白质组学与食管癌关系的研究进展[J]. 癌变·畸变·突变, 2010, 22(6): 488-490.
[15]	赵群（综述）/ 邓小虹（审校）. 蛋白质组学在卵巢癌诊治中的研究进展[J]. 癌变·畸变·突变, 2006, 18(3): 252-254.