中性粒细胞/淋巴细胞比值对多发性骨髓瘤患者的预后评估价值

目的探讨外周血中性粒细胞/淋巴细胞比值(NLR)在多发性骨髓瘤(MM)患者预后中的价值。方法回顾性分析87例初诊MM患者和100例体检健康者临床资料,将MM患者以NLR平均值为临界值分为低NLR组(NLR<2.68)和高NLR组(NLR≥2.68),分析2组性别、年龄、国际分期体系(ISS)、总体生存期、实验室检查结果等资料的差异,通过Kaplan-Meier法和Cox比例风险回归模型做单因素和多因素分析,确定影响MM患者的预后因素。结果MM组的NLR值明显高于健康对照组(t=2.21,P<0.05)。与低NLR组比较,高NLR组血清β2-微球蛋白(β2-MG)、钙、肌酐水平偏高,差异有统计学意义(P<0.05)。高NLR组较低NLR组总体生存期短、5年生存率低。单因素分析和多因素分析结果显示,NLR≥2.68,β2-MG升高是MM预后不良的危险因素及独立危险因素(P<0.05)。结论NLR是MM患者预后判断的1个独立危险因素,高水平NLR患者的总体生存期短,但需大样本资料证实。

The prognostic value of neutrophil/lymphocyte ratio in patients with multiple myeloma

Objective To investigate the prognostic value of peripheral blood neutrophil/lymphocyte ratio(NLR)in patients with multiple myeloma(MM).Methods The clinical data of 87 newly diagnosed MM patients and 100 healthy people were analyzed retrospectively.MM patients were divided into low NLR group(NLR<2.68)and high NLR group(NLR≥2.68)with the mean value of NLR as the critical value.The differences of sex,age,internation staging system(ISS),overall survival period and laboratory examination results between the two groups were analyzed,Kaplan-Meier method and Cox proportional risk regression model were used for single factor and multi factor analysis to determine the prognostic factors of MM patients.Results The NLR value of the MM group was significantly higher than that of the healthy control group(t=2.21,P<0.05).Compared with the low NLR group,the serumβ2-microglobulin(β2-MG),calcium and creatinine levels of the high NLR group were significantly higher(P<0.05).The high NLR group and the lower NLR group had a short overall survival and a low 5 year survival rate.Univariate analysis and multivariate analysis showed that NLR≥2.68,and elevatedβ2-MG were adverse risk factors and independent risk factors for MM prognosis(P<0.05).Conclusion NLR is an independent risk factor for the prognosis of MM patients.The overall survival of patients with high-level NLR is short,but large sample data is needed to confirm it.