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红细胞分布宽度/血小板计数对多发性骨髓瘤预后预测价值的研究
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Abstract:
目的：本研究旨在探讨RPR水平与多发性骨髓瘤(MM)患者预后的预测价值。方法：我们回顾性分析了161例新诊断的MM患者，收集患者临床资料，根据MM的预后确定RPR的最佳截断值，将MM患者分为高RPR组和低RPR组，比较两组之间临床资料的差异性，分析RPR对MM患者预后的影响。结果：RPR最佳截断值为0.115时预测价值最高，高RPR组和低RPR组总生存期(OS)的中位数均未达到，Kaplan-Meier生存分析显示两者间差异具有统计学意义(P < 0.001)。高RPR组的中位无进展生存期(PFS)短于低RPR组(26个月 vs. 49个月，P = 0.001)。COX回归分析显示，高龄、RPR > 0.115、肌酐 > 177 umol/L是OS的独立预后因素；RPR > 0.115是PFS的独立预后因素(P < 0.05)。结论：RPR是新诊断的MM患者的实用且有效的预后标志物，高RPR是MM患者OS和PFS的一个独立的不良预后因素。
Objective: The aim of this study was to investigate the prognosis value of RPR of MM patients. Methods: We retrospectively analysed 161 newly diagnosed MM patients, collected patients’ clinical data. According to the best cut off value of RPR on the prognosis of MM, they were divided into high RPR group and low RPR group. The differences in clinical data between the two groups were compared and the influence of RPR on the prognosis of MM was analyzed. Results: The best RPR cut off value was 0.115 when the predictive value was the highest. The median overall survival (OS) was not reached in both the high and low RPR groups, and Kaplan-Meier survival analysis showed that the difference was statistically significant (P < 0.001). The median progression-free survival (PFS) in the high RPR group and the low RPR group was 26 months and 49 months, respectively. The difference between the two groups was statistically significant (P = 0.001). COX regression analysis showed that advanced age, RPR > 0.115, and creatinine > 177 umol/L were independent prognostic factors for OS; RPR > 0.115 was an independent prognostic factor for PFS (P < 0.05). Conclusion: RPR is a practical and validated prognostic marker for newly diagnosed MM patients, and high RPR is an independent poor prognostic factor for OS and PFS in MM patients.
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