NLR、PLR和SII对多发性骨髓瘤预后评估的临床价值

目的：讨论中性粒细胞计数/淋巴细胞计数(NLR)、血小板计数/淋巴细胞计数(PLR)、系统免疫炎症指数(SII)与初诊多发性骨髓瘤(MM)病人预后的相关性。方法：59例初诊MM病人治疗半年后，根据病人转归情况分为缓解组(n=34)和未缓解组(n=25)。探讨NLR、PLR、SII与MM病人转归的关系，利用logistic回归分析探讨MM预后的独立危险因素，绘制ROC曲线评估预后价值。结果：缓解组与未缓解组间PLR、基础疾病、年龄、性别、血钙浓度、肌酐的差异均无统计学意义(P>0.05)。缓解组的NLR、SII均低于未缓解组(P<0.01)。多因素logistic回归分析显示，SII高水平是MM预后的独立危险因素(OR=1.005,P<0.05)。ROC曲线提示，SII对病人生存预测时曲线下面积为0.754,特异度为85.3%;NLR对病人生存预测时曲线下面积为0.722,特异度为79.4%。结论：NLR与SII可用于MM预后的评估，且SII的预后诊断价值优于NLR。

Clinical value of NLR,PLR and SII in prognostic evaluation of multiple myeloma

ObjectiveTo investigate the correlation between neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune inflammatory index (SII) and the prognosis of newly diagnosed multiple myeloma (MM) patients.MethodsAfter six months of treatment, the patients with MM for the first time were divided into the remission group (n=34) and non-remission group (n=25) according to their prognosis condition.The relationship among NLR, PLR, SII and the outcome of MM patients was explored, the independent risk factors of MM prognosis were analyzed by logistic regression analysis, and ROC curve was used to evaluate the prognostic value.ResultsThere were no significant differences in PLR, underlying diseases, age, gender, blood calcium concentration and creatinine between the remission group and the non-remission group (P>0.05).NLR and SII in remission group were lower than those in non-remission group (P < 0.01).Multivariate logistic regression analysis showed that high level of SII was an independent risk factor for MM prognosis (OR=1.005, P < 0.05).ROC curve analysis indicated that the area under the curve was 0.754 and the specificity was 85.3% when SII predicted the survival of patients.The area under the curve of NLR was 0.722 and the specificity was 79.4%.ConclusionsNLR and SII can be used to evaluate the prognosis of MM.Furthermore, the prognostic value of SII is better than NLR.