文章摘要
血清HSP90 ESR对初治多发性骨髓瘤患者预后的预测价值
The predictive value of serum HSP90 and ESR for prognosis of newly diagnosed multiple myeloma patients
投稿时间:2025-06-03  
DOI:10.3969/j.issn.1000-0399.2026.07.012
中文关键词: 多发性骨髓瘤  热休克蛋白90  红细胞沉降率  临床特征  预后
英文关键词: Multiple myeloma  Heat shock protein 90  Erythrocyte sedimentation rate  Clinical features  Prognosis
基金项目:张家口市科技计划项目(编号:2221095D)
作者单位
周素涛 075000 河北张家口 河北北方学院附属第一医院检验科 
王霞 075000 河北张家口 河北北方学院附属第一医院检验科 
郭娟 075000 河北张家口 河北北方学院附属第一医院检验科 
曹欣然 075000 河北张家口 河北北方学院附属第一医院检验科 
侯亚利 075000 河北张家口 河北北方学院附属第一医院检验科 
段娜娜 075000 河北张家口 河北北方学院附属第一医院药学部 
史伟勋 075000 河北张家口 河北北方学院附属第一医院检验科 
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中文摘要:
      目的 探讨血清热休克蛋白90(HSP90)、红细胞沉降率(ESR)对初治多发性骨髓瘤(MM)患者预后的预测价值。方法于2019年3月至2022年7月期间招募在河北北方学院附属第一医院接受治疗的121例初诊MM患者作为MM组,同期选取在本院进行体检的100例健康个体作为对照组。采用酶联免疫吸附测定法检测血清HSP90水平;采用魏氏法检测ESR水平;采用logistic回归分析MM发生的影响因素;采用受试者工作特征曲线评估血清HSP90、ESR水平对MM诊断及预后的预测价值;采用KaplanMeier生存曲线分析血清HSP90、ESR与MM患者预后的关系;采用Cox回归评估影响MM患者预后不良的因素。结果 MM组患者血清HSP90、ESR水平高于对照组(P<0.05)。HSP90、ESR水平升高是MM发生的危险因素(P<0.05)。血清HSP90、ESR以及二者联合诊断MM的曲线下面积(AUC)分别为0.816、0.887和0.921,联合诊断效果更佳(Z二者联合-HSP90=3.935、Z二者联合-ESR=2.511,P均<0.05)。死亡组患者血清HSP90、ESR水平及骨髓浆细胞≥60%、国际分期系统分期Ⅲ期的比例、乳酸脱氢酶(LDH)水平高于生存组(P<0.05)。HSP90、ESR低表达组的2年总生存率高于其高表达组(Log-rankχ2=7.654、4.605,P<0.05)。骨髓浆细胞≥60%以及血清LDH、HSP90、ESR水平升高是影响MM患者预后不良的危险因素(P<0.05),血清HSP90、ESR以及二者联合预测MM患者预后的AUC分别为0.662、0.764和0.846,二者联合检测具有更高的预测价值(Z二者联合-HSP90=3.516、Z二者联合-ESR=2.212,P<0.05)。结论 MM患者血清HSP90、ESR水平升高,二者联合检测对MM具有较高的诊断和预后预测价值,可作为评估MM发生、发展及预后的潜在指标。
英文摘要:
      Objective To explore the predictive value of serum heat shock protein 90(HSP90) and erythrocyte sedimentation rate(ESR) for the prognosis of newly diagnosed multiple myeloma(MM) patients. Methods From March 2019 to July 2022, 121 newly diagnosed MM patients treated at the First Affiliated Hospital of Hebei North University were recruited as the MM group. Concurrently, 100 healthy individuals undergoing physical examinations at the same hospital were selected as the control group. Enzyme linked immunosorbent assay was applied to detect serum HSP90 level. The Westergren method was applied to detect ESR level. The receiver operating characteristic curve was applied to evaluate the diagnostic and prognostic values of serum HSP90 and ESR levels in MM. Kaplan-Meier survival curves were used to analyze the relationship between serum HSP90, ESR, and prognosis in MM patients. Cox regression was applied to evaluate the factors affecting poor prognosis in MM patients. Results The levels of serum HSP90 and ESR in the MM group were higher than those in the control group(P<0.05). Elevated HSP90 and ESR levels were risk factors for multiple myeloma(P<0.05). The area under the curve(AUC) of serum HSP90, ESR, and their combined diagnosis of MM was 0.816, 0.887, and 0.921, respectively. The combined diagnostic effect was better(Zcombination-HSP90=3.935, Zcombination-ESR=2.511, P<0.05). The serum HSP90, ESR levels, and the proportions of bone marrow plasma cells ≥ 60%, ISS stage Ⅲ and lactate dehydrogenase(LDH) levels in the death group were higher than those in the survival group(P<0.05). The 2-year overall survival rate was higher in the low-expression groups for HSP90 and ESR compared to their high-expression counterparts(Log-rank χ2=7.654, 4.605, P<0.05). Bone marrow plasma cells ≥ 60% and elevated levels of serum LDH, HSP90, and ESR were risk factors for poor prognosis in MM patients(P<0.05). The AUC of serum HSP90, ESR, and their combination in predicting the prognosis of MM patients was 0.662, 0.764, and 0.846, respectively. The combined detection of the two had higher predictive value(Zcombination-HSP90=3.516, Zcombination-ESR=2.212, P<0.05). Conclusion The levels of serum HSP90 and ESR are elevated in MM patients, and they are closely related to the proportion of bone marrow plasma cells and ISS staging. The combined detection of the two has high diagnostic and prognostic values for MM, which can serve as a potential indicator for evaluating the occurrence, development, and prognosis of multiple myeloma.
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