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多发性骨髓瘤患者异常浆细胞CD27表达和免疫表型与肿瘤预后的关系

Relationships of abnormal plasma cell CD27 expression and immune phenotype with tumor prognosis in patients with multiple myeloma

    摘要
  • 摘要:
    目的 探讨多发性骨髓瘤(MM)患者异常浆细胞的CD27表达水平及其免疫表型与肿瘤预后的关系。
    方法 回顾性分析收治的61例初治MM患者的资料，分析异常浆细胞中CD27表达水平，比较CD27阳性与CD27阴性MM患者临床指标的差异。4个化疗疗程后分析CD27阳性与CD27阴性MM患者疗效，并对院内接受治疗的所有患者随访，进行生存分析。
    结果 对61例患者的浆细胞表型进行分析，发现其中21例患者骨髓异常浆细胞表型CD27表达阳性(CD27阳性组), 40例患者CD27表达阴性(CD27阴性组)。CD27阳性组患者异常浆细胞CD56+占比、外周血肌酐水平低于CD27阴性组, 淋巴细胞数高于阴性组，差异有统计学意义(P < 0.05)。CD27阳性组患者的乳酸脱氢酶(LDH)水平、β2微球蛋白水平及β2-血清蛋白占比低于CD27阴性组，差异有统计学意义(P < 0.05)。CD27阴性组IGH重排患者占比高于CD27阳性组，差异有统计学意义(P < 0.05)。CD27阴性组部分缓解(PR)以及PR+疾病稳定(SD)+疾病进展(PD)患者占比高于CD27阳性组，完全缓解(CR)与非常好的部分缓解(VGPR)患者占比低于CD27阳性组，差异有统计学意义(P < 0.05)。CD27阳性组的1、2年生存率均高于CD27阴性组，差异有统计学意义(P < 0.05)。Kaplan-Meier生存分析法显示，CD27阳性组的中位总生存期和中位无进展生存期为28、27个月，分别长于CD27阴性组的24、23个月，差异有统计学意义(P < 0.05)。
    结论 多发性骨髓瘤患者异常浆细胞CD27的低表达可能与不良预后相关。

     

    Abstract:
    Objective To explore the CD27 expression level of abnormal plasma cells in patients with multiple myeloma (MM) and immune phenotype and the relationships with tumor prognosis.
    Methods A retrospective analysis was conducted on the data of 61 newly diagnosed MM patients to evaluate the expression level of CD27 in abnormal plasma cells, and the differences in clinical indicators between CD27-positive and CD27-negative MM patients were compared. The efficacy of CD27-positive and CD27-negative MM patients was analyzed after four cycles of chemotherapy, and all patients receiving treatment in the hospital were followed up for survival analysis.
    Results Among the 61 patients, 21 had positive expression of CD27 in abnormal bone marrow plasma cells (CD27-positive group), and 40 had negative expression (CD27-negative group). The CD27-positive group had a lower proportion of CD56+ abnormal plasma cells and creatinine levels in peripheral blood and a higher lymphocyte count than the CD27-negative group (P < 0.05). The CD27-positive group also exhibited lower levels of lactate dehydrogenase (LDH), β2-microglobulin, and β2-globulin proportion than the CD27-negative group (P < 0.05). The proportion of IGH rearrangement patients was higher in the CD27-negative group than that in the CD27-positive group (P < 0.05). The CD27-negative group had a higher proportion of patients with partial response (PR) and PR+stable disease (SD)+progressive disease (PD), and a lower proportion of patients with complete response (CR) and very good partial response (VGPR) compared to the CD27-positive group(P < 0.05). The 1- and 2-year survival rates were higher in the CD27-positive group than in the CD27-negative group (P < 0.05). Kaplan-Meier survival analysis revealed that the median overall survival and median progression-free survival were 28 and 27 months, respectively, in the CD27-positive group, which was longer than the 24 and 23 months in the CD27-negative group (P < 0.05).
    Conclusion Low expression of CD27 in abnormal plasma cells of multiple myeloma patients may be associated with poor prognosis.

     

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