基于潜在类别分析的不同CD73多发性骨髓瘤患者预后复发的影响因素分布特征研究

目的 探究多发性骨髓瘤(MM)患者复发的影响因素,并分析不同CD73⁺表达率患者复发影响因素的分布特征。方法 选择2017年2月—2021年2月我院收治的108例MM患者作为研究对象,根据治疗后1年的复发情况分为复发组和未复发组。筛选影响患者复发的因素;采用聚类分析和潜在类别分析方法分析不同CD73患者复发影响因素的分布特征。结果 108例患者的复发率为23.15%(25/108);男性、体质指数(BMI)＜20 kg/m²、国际分期系统(ISS)分期Ⅲ期、高危遗传学风险、β2-微球蛋白(β2-MG)≥3.5 mg/L、p53基因缺失、CD73⁺均是导致患者复发的危险因素(P＜0.05),维持治疗是保护因素(P＜0.05)。聚类分析结果显示,复发风险呈明显聚集性,可将患者分为复发高风险组(CD73⁺表达率＞40%)和低风险组(CD73⁺表达率＜40%),复发率分别为37.50%(15/40)和14.71%(10/68),差异具有统计学意义(P＜0.05);潜在类别分析结果显示,复发高风险组“危险因素较少型分布”比例明显低于复发低风险组,“ISS分期Ⅲ期未维持治疗分布”比例明显高于复发低风险组(P＜0.05),两组“ISS分期Ⅲ期维持治疗分布”比例差异无统计学意义(P＞0.05)。结论 性别、BMI、ISS分期等因素均与MM患者复发相关;CD73⁺表达率＞40%的患者复发风险较高,影响因素主要为“ISS分期Ⅲ期未维持治疗分布”。

Analysis of the distribution characteristics of influencing factors for prognosis and recurrence of different CD73 multiple myeloma patients based on latent class

Objective The aim of this study was to explore the influencing factors of recurrence in patients with multiple myeloma(MM),and to analyze the distribution characteristics of factors affected recurrence in patients with different CD73⁺ expression rates.Methods A total of 108 patients with MM who were treated in our hospital from February 2017 to February 2021 were selected as the research subjects,and they were divided into a recurrence group and a non-recurrence group according to the recurrence one year after treatment.The factors affected the recurrence of patients were screened;cluster analysis and latent class were used to analyze the distribution characteristics of the factors affecting the recurrence different CD73 patients.Results The recurrence rate of 108 patients was 23.15%(25/108).Male,body mass index(BMI)＜20 kg/m²,international staging system(ISS)stage Ⅲ,high-risk genetic risk,β2-microglobulin(β2-MG)≥3.5 mg/L,p53 gene deletion,and CD73⁺ were independent risk factors for relapse(P＜0.05).Maintenance therapy was a protective factor(P＜0.05).The results of cluster analysis showed that the recurrence risk was obviously clustered,and the patients could be divided into a high-risk group(the expression rate of CD73⁺＞40%)and a low-risk group(the expression rate of CD73⁺＜40%),with a recurrence rates of 37.50%(15/40)and 14.71%(10/68),the difference was statistically significant(P＜0.05).The results of latent class analysis showed that the proportion of patients with “less risk factor distribution” in the high-risk group for recurrence was significantly lower than that in the low-risk group for recurrence,and the proportion of patients with “distribution for ISS stage Ⅲ without maintenance treatment” was significantly higher than that in the low-risk group for recurrence(P＜0.05),there was no significant difference in the proportion of patients in the “ISS stage Ⅲ maintenance treatment distribution” between the two groups(P＞0.05).Conclusion Gender,BMI,ISS stage and other factors are related to the recurrence of MM patients.Patients with ＞40% of CD73⁺ expression rate have a higher risk of recurrence,and the main influencing factor is “ISS stage Ⅲ without maintenance treatment distribution”.