多发性骨髓瘤患者CD200的表达及与预后的关系

目的:探讨CD200在多发性骨髓瘤（multiple myeloma,MM）中的表达及其与预后的关系。方法:选取初诊的MM患者71例，利用流式细胞术（FCM）检测MM细胞中CD200的表达，检测了其中40例患者外周血T细胞亚群百分比。收集受试者临床资料，通过随访获取总生存期（OS），采用Kaplan-Meier法绘制生存曲线、Cox比例风险回归分析CD200表达与MM患者预后的关系。结果:71例MM患者中，51例（71.8%）阳性表达CD200，20例（28.2%）不表达CD200。CD200+MM患者CD4+T百分比和CD4/CD8比值低于CD200-患者（P<0.05）。CD200-MM患者中位总生存期（OS）为26.0（95%CI 18.7~33.2）个月，CD200+患者中位OS时间未达到（χ2=4.210，P=0.040）。CD200+MM患者1年和2年的OS率为66.7%和42.5%，CD200-MM患者1年和2年的OS率为72.9%和60.6%。Cox回归风险模型分析结果显示MM患者年龄＞65岁［HR=4.145（95%CI 1.252~13.728），P=0.020］、CD200阳性［HR=2.617（95%CI 1.044~6.561），P=0.040］是独立于其他临床指标的预后危险因素。结论:MM患者 CD200表达存在异质性，CD200阳性表达是MM患者OS的不良预后因素。

Expression of CD200 in multiple myeloma and the relationship with prognosis

Objective:To explore the CD200 expression in multiple myeloma(MM) and its relationship with prognosis.Methods:The expression of CD200 was tested in 71 new cases of MM,and the percentage of T cell subsets in 40 of these patients were determined by flow cytometry.The clinical data of patients were reviewed,obtaining overall survival(OS) by follow-up,CD200 expression and prognosis of patients was analyzed by Kaplan-Meier and Cox proportional hazard regression.Results:CD200 was expressed in 51 cases(71.8%) and not in 20 cases(28.2%) from 71 MM patients.The percentage of CD4+T cells and CD4/CD8 in CD200+patients were lower than those in CD200-patients(P<0.05).The median overall survival(OS) of CD200-MM patients was 26.0(95%CI 18.7~33.2) months,the median OS of CD200+patients was not reached(χ2=4.210，P=0.040).The one-year,2-year OS for CD200+MM was 66.7% and 42.5%，while one-year,2-year OS for CD200-MM was 72.9% and 60.6% respectively.Cox risk regression model analysis showed that age≥65 years(HR=4.145,95%CI 1.252~13.728,P=0.020),CD200 positive(HR=2.617,95%CI 1.044~6.561,P=0.040) were independent risk prognostic factors.Conclusion:CD200 expression is heterogeneous,positive expression is a risk prognostic factor of OS in MM patients.