多发性骨髓瘤预后影响因素分析

摘要

目的 探讨影响多发性骨髓瘤(MM)患者总体生存时间(OS)和疾病无进展时间(PFS)的因素,并比较D-S及ISS分期的一致性. 方法 收集我院初治的176 例 MM 患者临床及实验室资料,并对其进行 D-S 及 ISS 分期,应用Kaplan-Meier法计算OS及PFS,Log-Rank检验分析相关因素对 OS、PFS的影响,采用 Cox 回归分析进行多变量分析;采用Kappa分析对D-S分期及ISS分期进行一致性分析. 结果 不同年龄的MM患者PFS比较,差异有统计学意义(P<0.05). 不同性别、年龄、乳酸脱氢酶、血肌酐、ISS分期及疗效MM患者的OS比较,差异有统计学意义(P<0.05),Cox回归分析结果显示年龄及疗效对OS有独立的预测价值(P<0.05). ISS分期与D-S分期一致性较好(Kappa=0.358,P<0.001). 结论 疗效及年龄可作为MM患者的OS的独立预后因素,年龄与PFS有关,ISS分期与D-S分期有较好的一致性,但ISS分期可更好地评估MM患者的预后.%Objective To explore the factors which influence overall survival( OS) and progression-free survival( PFS) in patients with multiple myeloma ( MM ) , and to compare the consistency between Durie-Salmon staging system ( D-S ) staging and International Staging System( ISS) staging.Methods The clinical features and laboratory data of 176 patients with MM were collected,and the staging was performed using D-S and ISS for all patients.OS and PFS were calculated with Kaplan-Meier.The factors influencing OS and PFS were analyzed using Log-Rank test,and multivariate analysis was performed with Cox regression analysis.A consistency analysis of D-S staging and ISS staging was conducted using Kappa analysis.Results There was significant difference in PFS among patients with different ages (P<0.05).Significant difference in OS was observed among patients with different gender,age,lactate dehydrogenase,serum creatinine,ISS staging and efficacy ( P <0.05 ) .Cox regression analysis showed that age and efficacy had independent prognostic value for OS (P<0.05).There was a good consistency between D-S staging and ISS staging(Kappa=0.358,P<0.001).Conclusion Efficacy and age are the independent prognostic factors for OS in patients with MM,and age correlates with PFS.There is a good consistency between D-S staging and ISS staging,but ISS staging can evaluate the prognosis for patients with MM better.