血清基质金属蛋白酶-13联合β2微球蛋白检测在多发性骨髓瘤诊断和预后中的价值分析-现代医学

血清基质金属蛋白酶-13联合β2微球蛋白检测在多发性骨髓瘤诊断和预后中的价值分析

单位：南通大学附属海安医院输血科, 江苏海安 226600

分类号：R733.3

出版年·卷·期（页码）：2018·46·第十二期（1349-1354）

摘要：

目的：探讨血清基质金属蛋白酶-13（MMP-13）联合β2微球蛋白（β2-microglobulin，β2-MG）检测在多发性骨髓瘤（MM）诊断和预后中的临床价值。方法：选择2013年1月至2016年12月于我院就诊的MM患者76例作为病例组，同期选取我院健康体检者60例作为对照组。根据治疗后的疗效将病例组分为难治组（34例）和缓解组（42例），难治组的纳入标准为疗效未达到部分缓解（PR）等级，缓解组的纳入标准为疗效达到PR及以上。分别采用化学发光法和酶联免疫吸附法（ELISA）检测研究对象血清β2-MG和MMP-13水平。依据MMP-13和β2-MG水平的中位数将MM患者分为高MMP-13和低MMP-13组、高β2-MG和低β2-MG组，并进行比较分析。结果：病例组化疗前血清MMP-13和β2-MG水平分别为59.6 pg·ml^-1和8.3 mg·L^-1，对照组血清MMP-13和β2-MG水平分别为28.7 pg·ml^-1和2.9 mg·L^-1，病例组血清MMP-13和β2-MG水平均高于对照组，差异具有统计学意义（P<0.05）。缓解组治疗后血清MMP-13和β2-MG水平较治疗前均降低，差异具有统计学意义（P<0.05）；治疗前及治疗后缓解组患者血清MMP-13和β2-MG水平均低于难治组，差异具有统计学意义（P<0.05）。联合检测血清MMP-13和β2-MG区分缓解组与难治组的灵敏度为79.7%，特异度为92.8%。与低MMP-13组相比，高MMP-13组患者的生存时间显著降低（log-rank P=0.023）；与低β2-MG组相比，高β2-MG组患者的生存时间也显著降低（log-rank P=0.005）。结论：血清MMP-13和β2-MG联合检测在MM诊断及预后评估中具有重要的临床意义。

Objective: To investigate the clinical value of serum matrix metalloproteinase-13 (MMP-13) combined with β2-microglobulin (β2-MG) in the diagnosis and prognosis of multiple myeloma (MM). Methods: 76 cases of MM patients admitted to our hospital during the period from January 2013 to December 2016 were collected as the case group. During the same period, 60 cases of healthy examined people in our hospital were selected as the control group. According to the curative effect after treatment, the patients were divided into refractory group (34 cases) and remission group (42 cases). The inclusion criterion of refractory group was that the curative effect did not reach the partial response (PR) grade, and the inclusion criterion of remission group was that the curative effect reached PR and above. The serum levels of β2-MG and MMP-13 were detected by chemiluminescence and enzyme-linked immunosorbent assay (ELISA). MM patients were divided into high MMP-13 and low MMP-13 groups, high β2-MG and low β2-MG groups according to the median MMP-13 and β-2-MG levels. Results: The serum MMP-13 and β2-MG levels in the case group before chemotherapy were 59.6 pg·ml^-1 and 8.3 mg·L^-1, respectively. The levels of serum MMP-13 and β2-MG in the control group were 28.7 pg·ml^-1 and 2.9 mg·L^-1, respectively. The levels of serum MMP-13 and β2-MG in the case group were higher than those in the control group, and the difference was statistically significant (P<0.05). The levels of serum MMP-13 and β2-MG in the remission group after treatment were lower than those before treatment, and the difference was statistically significant (P<0.05). Before treatment and after treatment, the serum MMP-13 and β2-MG levels in the remission group were lower than those in the refractory group, and the difference was statistically significant (P<0.05). When combined with MMP-13 and β2-MG, the sensitivity and specificity to distinguish between the remission group and the refractory group was 79.7% and 92.8%, respectively. Compared with the low MMP-13 group, the survival time of patients in the high MMP-13 group was significantly lower (log-rank P=0.023). The survival time of the high β2-MG group was also significantly lower than that of the low β2-MG group (log-rank P=0.005).Conclusion: Detection of serum MMP-13 combined with β2-MG has an important clinical significance in the diagnosis and evaluation of MM prognosis.

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