發(fā)布時(shí)間：2019-08-12 10:26

【摘要】：目的:探討染色體異常對硼替佐米治療初治多發(fā)性骨髓瘤(MM)療效及預(yù)后的影響。方法:收集本院2008年1月至2011年12月收治的152例初治MM患者資料,對患者均采用以硼替佐米為主的多藥聯(lián)合化療方案治療并于4個用期后分析療效;同時(shí)制備染色體標(biāo)本,分別采用R顯帶技術(shù)和DNA序列探針進(jìn)行核型和基因(RB1缺失、D13S319缺失、P53缺失、IgH重排和1q21擴(kuò)增)分析,分析總體療效及染色體異�；颊叩寞熜Ш瓦h(yuǎn)期生存情況,采用Kaplan-Meier法進(jìn)行生存分析,COX風(fēng)險(xiǎn)比例模型進(jìn)行多因素分析。結(jié)果:152例MM患者中檢出核型異常者47例(30.92%),RB1異常者43例(28.29%),D13S319異常者49例(32.24%),P53異常者30例(19.74%),IgH異常者58例(38.16%),1q21異常者33例(21.71%)。全組152例患者的療效均可以評價(jià),其中獲CR、nCR、PR、MR和PD者分別為24、54、21、14和39例,總有效率為74.34%,顯效率為50.66%;核型、D13S319、P53及IgH異常者的總有效率和顯效率均低于相應(yīng)正常者(P0.05),RB1、1q21異常者的顯效率均低于相應(yīng)正常者(P0.05);全組隨訪22-72個月,中位隨訪52.0個月,截至隨訪日期,中位生存期(OS)尚未達(dá)。不同染色體異常者的中位OS均低于正常者(P0.05);經(jīng)COX多因素模型分析發(fā)現(xiàn),染色體異常均為影響MM預(yù)后的獨(dú)立因素,如核型、RB1、D13S319、P53、IgH和1q21異常相對于正常者的風(fēng)險(xiǎn)分別提高了3.124、1.177、2.639、6.552、2.045和7.264倍,差異均有統(tǒng)計(jì)學(xué)意義。結(jié)論:染色體異�？捎绊懪鹛孀裘字委煶踔蜯M的療效及預(yù)后,檢測染色體異常對初治MM的治療有一定參考價(jià)值。
[Abstract]:Objective: to investigate the effect of chromosome abnormality on the efficacy and prognosis of bortezomib in the treatment of (MM) in patients with multiple myeloma. Methods: the data of 152 patients with MM treated in our hospital from January 2008 to December 2011 were collected. All the patients were treated with bortezomib combined chemotherapy regimen and the curative effect was analyzed after 4 periods of use. At the same time, chromosome specimens were prepared and karyotype and gene (RB1 deletion, D13S319 deletion, p53 deletion, IgH rearrangement and 1q21 amplification) were analyzed by R banding technique and DNA sequence probe, respectively. the overall curative effect and the curative effect and long-term survival of patients with chromosome abnormality were analyzed. Kaplan-Meier method was used for survival analysis and COX risk ratio model was used for multivariate analysis. Results: abnormal karyotype was found in 47 cases (30.92%), abnormal RB1 in 43 cases (28.29%), abnormal D13S319 in 49 cases (32.24%), abnormal p53 in 30 cases (19.74%) in 58 cases (38.16%), abnormal 1q21 in 33 cases (21.71%), and abnormal karyotype in 47 cases (30.92%), abnormal RB1 in 43 cases (28.29%), abnormal D13S319 in 49 cases (32.24%), abnormal p53 in 58 cases (38.16%) and abnormal 1q21 in 33 cases (21.71%). The total effective rate and effective rate of CR,nCR,PR,MR and PD were 24, 54, 21, 14 and 39, respectively, the total effective rate was 74.34%, the effective rate was 50.66%, the total effective rate and effective rate of abnormal p53 and IgH were lower than those of the corresponding normal group (P 0.05), and the effective rate of abnormal RB1,1q21 was lower than that of the corresponding normal group (P 0.05). The follow-up period was 22 鈮，

本文編號：2525652