血清IL-9、IL-18及IL-32水平对多发性骨髓瘤患者肾损伤的诊断价值

庄妮拉; 詹文丽; 莫泰金; 李小淦; 曾祥兴; 王秋香

doi:10.3969/j.issn.1671-2390.l20-188

血清IL-9、IL-18及IL-32水平对多发性骨髓瘤患者肾损伤的诊断价值

Diagnostic value of serum levels of interleukin-9,interleukin-18 and interleukin-32 in patients with multiple myeloma

摘要

摘要: 目的探讨多发性骨髓瘤（multiple myeloma，MM）患者血清白细胞介素-9（interleukin-9，IL-9）、白细胞介素-18（interleukin-18，IL-18）及白细胞介素-32（interleukin-32，IL-32）的表达及其预测肾损伤的价值。方法选取2016年1月至2019年12月我院收治的78例MM患者，依据国际分期系统（International Staging System，ISS）分为I期（n=15）、Ⅱ期（n=26）和Ⅲ期（n=37），根据肾功能情况，将其分为肾损伤组（n=28）和无肾损伤组（n=50）。另选取同期50例正常者作为对照组。检测各组血清IL-9、IL-18、IL-32及β₂-微球蛋白（β₂-microglobulin，β₂-MG）水平。应用受试者工作特征（receiver operating characteristic，ROC）曲线分析血清IL-9、IL-18、IL-32及β₂-MG水平诊断MM患者肾损伤的价值。采用Pearson相关分析MM患者血清IL-9、IL-18、IL-32水平与β₂-MG的相关性。结果 MM组与对照组相比血清IL-9（63.15±18.36）ng/L比（22.78±7.15）ng/L、IL-18（580.64±70.35）ng/L比（174.30±26.82） ng/L、IL-32（817.62±112.36）ng/L比（260.85±34.70）ng/L及β₂-MG（6.50±2.52）mg/L比（1.66±0.58）mg/L水平均明显高于对照组（P<0.01）。随着ISS分期的增加，MM患者血清IL-9、IL-18、IL-32及β₂-MG水平增加（P<0.01）。肾损伤组与无肾损伤组相比，血清IL-9（91.26±19.42）ng/L比（45.30±14.20）ng/L、IL-18（812.46±95.27）ng/L比（407.28±53.60）ng/L、IL-32（1130.85±154.70）ng/L比（ 604.20±71.38）ng/L及β₂-MG（10.18±4.75）mg/L比（3.15±1.06）mg/L水平均明显高于无肾损伤组（P<0.01）。ROC曲线分析显示，IL-9、IL-18、IL-32及β₂-MG四项联合诊断MM患者发生肾损伤的曲线下面积（0.963，95%CI：0.905~0.997）最大，其灵敏度和特异度为98.6%和81.2%。相关分析显示，MM患者血清IL-9、IL-18、IL-32与β₂-MG均呈正相关（P<0.01）。结论血清IL-9、IL-18、IL-32水平在MM患者中明显升高，且与MM患者的病情分期及肾损伤有关，联合β₂-MG检测对诊断MM患者发生肾损伤具有良好价值。

Abstract: Objective To explore the serum expressions of interleukin-9(IL-9),interleukin-18(IL-18) and interleukin-32(IL-32) in patients with multiple myeloma(MM) and examine their values in predicting renal injury.Methods Seventy-eight MM patients from January 2015 to December 2019 were divided into phase I(n=15),phase II(n=26) and phase III(n=37) according to the International Staging System.Based upon renal function,they were divided into renal injury group(n=28) and renal non-injury group(n=50).Another 50 normal subjects in the same period were selected as control group.The serum levels of IL-9,IL-18,IL-32 and β₂-microglobulin(β₂-MG) were detected in each group.Receiver operating characteristic(ROC) curve was utilized for examining the values of serum levels of IL-9,IL-18,IL-32 and β₂-MG in the diagnosis of renal injury.Pearson's correlation analysis was utilized for examining the correlation between serum levels of IL-9,IL-18,IL-32 and β₂-MG.Results The serum levels of IL-9(63.15±18.36) ng/L vs (22.78±7.15) ng/L,IL-18(580.64±70.35) ng/L vs (174.30±26.82) ng/L,IL-32(817.62±112.36) ng/L vs (260.85±34.70) ng/Land β₂-MG(6.50±2.52) mg/L vs (1.66±0.58) mg/Lwere significantly higher in MM group than those in control group(P<0.001).With the advancing of ISS stage,the serum levels of IL-9,IL-18,IL-32 and β₂-MG spiked in MM patients(P<0.001).The serum levels of IL-9(91.26±19.42) ng/L vs (45.30±14.20) ng/L,IL-18(812.46±95.2) ng/L vs (407.28±53.60) ng/L,IL-32(1130.85±154.70) ng/L vs (604.20±71.38) ng/Land β₂-MG(10.18±4.75) mg/L vs (3.15±1.06) mg/Lwere significantly higher in renal injury group than those in renal non-injury group(P<0.001).ROC curve analysis revealed that the area under the curve(0.963,95%CI:0.905-0.997) of IL-9,IL-18,IL-32 and β₂-MG combined diagnosis of renal injury in MM was the largest and its sensitivity and specificity were 98.6% and 81.2%.Correlation analysis showed that serum levels of IL-9,IL-18,IL-32 and β₂-MG were positively correlated in MM patients(P<0.001).Conclusion The serum levels of IL-9,IL-18 and IL-32 are significantly elevated in MM patients.Correlated with disease stage and renal injury,combine detection of β₂-MG has an excellent value in the diagnosis of renal injury in MM patients.

HTML全文

参考文献(20)

施引文献

资源附件(0)