Application of cystatin C and β2-microglobulin in the assessment of condition and short-term efficacy of multiple myeloma / 国际肿瘤学杂志

ABSTRACT

Objective To explore the application value of serum cystatin C (Cys-C)and β2-micro-globulin (β2-MG)in the diagnosis and short-term efficacy evaluation of multiple myeloma (MM). Methods A total of 450 patients with MM admitted to Anqing Hospital of Chinese People's Liberation Army Navy and Jin-hua Central Hospital of Zhejiang Province from October 2016 to October 2018 were selected as subjects (MM group),according to the Durie-Salmon staging criteria,including 150 patients in stage Ⅰ,Ⅱ and Ⅲ. A total of 150 healthy subjects were selected as the control group. The levels of Cys-C and β2-MG in the serum of the subjects were determined. The differences of Cys-C and β2-MG levels between the two groups and the MM patients with different Durie-Salmon stages were compared. The differences of Cys-C and β2-MG levels between the patients with different short-term efficacy were compared. The receiver operating characteristic (ROC) curve was used to analyze the value of the two indicators in the evaluation of MM efficacy,and the correlation between Cys-C and β2-GM was analyzed. Logistic regression analysis was used to analyze the multiple factors affecting the clinical efficacy of MM patients. Results The levels of Cys-C and β2-MG in the serum of the patients with MM were (2. 11 ± 0. 78)mg/ L and (6. 07 ± 3. 08)g/ L respectively,and those in the control group were (0. 75 ± 0. 20)mg/ L and (1. 78 ± 0. 59)g/ L,with significant differences (t = 33. 848,P <0. 001;t = 28. 084,P < 0. 001). The Cys-C levels of Durie-Salmon stage Ⅰ,Ⅱ and Ⅲ patients were (0. 99 ± 0. 21)mg/ L,(1. 36 ± 0. 17)mg/ L and (3. 07 ± 1. 02)mg/ L respectively,and the difference was statistically significant (F = 44. 157,P < 0. 001). The β2-MG levels in the serum of patients with stage Ⅰ,Ⅱand Ⅲ were (2. 57 ± 0. 75)g/ L,(4. 66 ± 1. 43)g/ L,(8. 63 ± 2. 26)g/ L respectively,and the difference was statistically significant (F = 57. 285,P < 0. 001). In all the patients,338 patients were effective,accoun-ting for 75. 11％,and 112 patients were ineffective,accounting for 24. 89％ . The levels of Cys-C and β2-MG in the serum of the effective MM patients were (1. 28 ± 0. 23)mg/ L and (2. 82 ± 0. 78)g/ L,and those of ineffective patients were (2. 97 ± 0. 77)mg/ L and (6. 22 ± 1. 92)g/ L,with statistically significant differences (t = 35. 874,P < 0. 001;t = 26. 633,P < 0. 001). The sensitivity of serum Cys-C for predicting short-term efficacy was 83. 0％,the specificity was 76. 6％,and those of serum β2-MG were 89. 3％ and 73. 6％ . The area under curve (AUC)of the serum Cys-C was 0. 813 (95％ CI0. 764-0. 862),and the AUC of serumβ2-MG was 0. 865 (95％ CI0. 825-0. 906),with a statistically significant difference (Z = 2. 490,P =0. 011). Spearman correlation analysis showed a positive correlation between serum Cys-C and β2-MG (r =0. 539,P = 0. 041). Logistic regression analysis showed that both β2-MG (95％ CI2. 386-5. 144,P <0. 001)and Cys-C (95％ CI2. 367-9. 702,P < 0. 001)were independent factors affecting the short-term effi-cacy of MM. Multivariate analysis showed that β2-MG (95％ CI3. 549-13. 739,P = 0. 001 )was an independent factor affecting the efficacy of MM. Conclusion The levels of serum Cys-C and β2-M in MM patients are significantly higher than those in healthy people,and they show an increasing trend with the pro-gression of MM disease,which can be used as markers for the pathological staging diagnosis of MM patients. The short-term efficacy of the patients can be evaluated by using the two indicators,and the clinical significance in efficacy evaluation of β2-MG is slightly better than that of Cys-C.