摘要
背景与目的:多发性骨髓瘤(multiplemyeloma,MM)是一种异质性的浆细胞肿瘤,预后不良。本研究旨在探讨我国MM患者的预后因素和适用的临床分期。方法:对206例MM患者的18项临床和实验室指标进行单因素和多因素分析,并将患者分别按4种分期法进行分期,比较各期患者的生存情况。结果:206例患者中男性138例,女性68例,中位年龄59岁(27～90岁),中位生存期为33个月,2年生存率为64.7%,5年生存率为33.7%。单因素分析发现,年龄、骨髓浆细胞总数、血红蛋白、血小板计数、校正钙浓度、白蛋白、肌酐、β2微球蛋白、C反应蛋白、骨病分级与预后相关。多因素分析显示C反应蛋白、β2微球蛋白、白蛋白、年龄为独立的预后因素。DurieSalmon(DS)分期、Bataille分期中三期间和国际分期系统(ISS)中Ⅰ期、Ⅱ期患者的生存期有显著性差异;英国医学研究理事会(BMRC)分期中三期间和ISS分期中Ⅱ期、Ⅲ期患者的生存期无显著性差异。结论:高C反应蛋白、高β2微球蛋白、低白蛋白、高龄的患者预后较差,DS分期和Bataille分期对我国患者比较适合。
BACKGROUND ＆ OBJECTIVE： Multiple myeloma （MM） is a heterogeneous disease of plasma cell tumor with poor prognosis. This study was to explore the prognostic factors of MM in China, and find the most suitable clinical staging systems. METHODS： Univariate and multivariate analyses were carried out on 18 clinical and laboratory indexes from 206 MM patients. These MM patients were classified according to 4 staging systems to compare their survival status. RESULTS. Of the 206 patients, 138 were men and 68 were women, with median age of 59 years （ranged 27-90 years） and median survival time of 33 months. The 2- and 5-year survival rates were 64.7% and 33.7%. Univariate analysis identified 10 prognostic factors： age, the amount of bone marrow plasma cells, hemoglobin, platelet count, adjusted serum calcium, albumin, creatinine, β2 microglobulin, C-reactive protein, and skeletal disease stage. Multivariate analysis showed that C- reactive protein, β2 microglobulin, albumin, age were independent prognostic factors. Significant differences of survival period existed among the 3 groups classified according to Durie Salmon staging system and Bataille staging system as well as between group Ⅰ and group Ⅱ of International staging system. However, no significant difference was found among the 3 groups classified according to British Medical Research Council staging system and between group Ⅱ and group Ⅲ of International staging system. CONCLUSIONS： High level of C-reactive protein, high level of microglobulin, low level of albumin and old age are correlated to poor prognosis. Dude Salmon staging system and Bataille staging system are suitable for Chinese MM patients.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2006年第4期461-464,共4页
Chinese Journal of Cancer
关键词
多发性骨髓瘤
单因素分析
多因素分析
预后
临床分期
Multiple myeloma
Univariate analysis
Multivariate analysis
Prognosis
Clinical staging system
