HMGB1、维生素D3 水平与多发性骨髓瘤的相关性

Correlation between the levels of HMGB1, vitamin D3 and multiple myeloma

摘要:

目的 检测多发性骨髓瘤（MM）患者血清高迁移率族蛋白B1（HMGB1）、维生素D3 水平变化， 分析其与病情进展的关系。方法 选取2012 年1 月—2013 年12 月在邯郸市中心医院治疗的MM 患者145 例作为研究组，以及150 例健康体检者作为对照组。采用酶联免疫吸附试验检测血清HMGB1、维生素D3、 β2 微球蛋白（β2-M）及乳酸脱氢酶（LDH）水平；比较MM 不同分期及随访后不同预后[ 完全缓解（CR） 及部分缓解后复发] 患者血清HMGB1、维生素D3、β2-M 及LDH 水平。分析血清HMGB1、维生素D3 水 平与β2-M、LDH 的相关性，绘制受试者工作特征（ROC）曲线分析血清HMGB1、维生素D3 对MM 患 者预后的预测价值。结果 与对照组比较，研究组血清HMGB1、β2-M 及LDH 升高，而维生素D3 降低 （P <0.05）；研究组I 期、Ⅱ期、Ⅲ期组MM 血清HMGB1、β2-M 及LDH 逐渐升高，而维生素D3 逐渐降低 （P <0.05）。CR 患者血清HMGB1、β2-M 及LDH 低于部分缓解后复发患者，而维生素D3 高于部分缓解后 复发患者（P <0.05）。MM 患者血清HMGB1 水平与β2-M、LDH 呈正相关（r =0.524 和0.412，P <0.05）， 而维生素D3 水平与β2-M、LDH 呈负相关（r =-0.401 和-0.382，P <0.05）。ROC 曲线分析显示，联合检 测血清HMGB1、VD3 对MM 患者预后预测的敏感性、特异性分别为77.6% 和74.5%，高于2 指标单独检测。 结论 MM 患者血清HMGB1 水平升高，维生素D3 水平降低，HMGB1、维生素D3 可能影响疾病的发生、发 展，可作为MM 病情评估和预后预测的辅助指标。

Abstract:

Objective To detect the serum levels of high mobility group protein B1 (HMGB1), Vitamin D3, and to explore their correlations with the progress of patients with multiple myeloma (MM). Methods The serum samples from 145 cases of MM patients and 150 cases of healthy volunteers were collected, the enzyme linked immunosorbent assay (ELISA) was used to determine the levels of serum HMGB1, vitamin D3, 2-microglobulin (β2-M) and lactate dehydrogenase (LDH). The levels of serum HMGB1, Vitamin D3, β2-M, LDH in MM patients in different stages and with different prognosis (totally recover and relapse after partially recover) after follow-up were compared. The correlation between the levels of serum HMGB1/Vitamin D3 with levels of serum β2-M / LDH were analyzed. Predictive values of serum HMGB1 and vitamin D3 on prognosis of MM patients were evaluated by receiver operating characteristic (ROC) curve analysis. Results Compared to the healthy volunteers, the levels of serum HMGB1, β2-M, LDH in MM patients increased, while the level of serum vitamin D3 decreased (P < 0.05). The levels of serum HMGB1, β2-M and LDH in MM patients with stage I, II and III increased gradually. The level of serum vitamin D3 decreased gradually (P < 0.05). In the patients who totally recover, the levels of serum HMGB1, β2-M, LDH were lower than those in the patients who suffer a relapse after partially recover, and the level of serum Vitamin D3 was higher (P < 0.05). In MM patients, the level of serum HMGB1 was positively related with levels of serum β2-M and LDH,the difference was statistically significant (P < 0.05). There were positive correlations between serum HMGB1 and β2-M, LDH in MM patients (r = 0.524 and 0.412, P < 0.05); the level of serum vitamin D3 was negatively related with level of serum β2-M and LDH, the difference was statistically significant (r = -0.401 or -0.382, P < 0.05). The results of ROC curve showed that the sensitivity and specificity of combined detection of serum HMGB1 and vitamin D3 for predicting the prognosis of MM patients were 0.776 and 0.745, respectively, which were higher than those of single detection of them. Conclusions The level of serum HMGB1 increased and the level of serum vitamin D3 decreased, which has influence on the occurrence and progress of MM. They may be used as an auxiliary index for evaluating MM condition and predicting prognosis.