Objective: To analyze the influence of bone marrow involvement (BMI) in patients with malignant lymphoma (ML) on laboratory indexes, and evaluate the laboratory markers that can be used to predict/diagnose BMI.
Methods: The clinical characteristics and laboratory indexes of 137 ML patients were analyzed retrospectively, from which the indexes of BMI in ML patients was studied. The logistic regression analysis and receiver operating curve (ROC) were used to evaluate independent risk factors and predictors of BMI diagnosis in ML patients.
Results: Compared with non-BMI group, the red blood cell distribution width, C-reactive protein, erythrocyte sedimentation rate, D-dimer, lactate dehydrogenase, alkaline phosphatase, β2-microglobulin, transferrin, CA153, CA125, and soluble interleukin-2 receptor (sIL-2R) levels were increased while platelet (PLT) count was decreased in BMI group, and the difference was statistically significant (P<0.05). The blood indexes related to BMI and the statistically significant indexes in the univariate regression analysis were corrected by multivariate logistic regression analysis. The corrected results showed that T cell-related non-Hodgkin lymphoma (adjusted OR=2.18, 95%CI: 1.48-4.90, P＜0.001), clinical stage Ⅲ-Ⅳ (adjusted OR=3.32, 95%CI: 2.16-5.83, P＜0.001), sIL-2R (adjusted OR=4.26, 95%CI: 2.95-12.85, P＜0.001) were the risk factors for ML patients with BMI, while PLT (adjusted OR=0.89, 95%CI: 0.55-0.96, P= 0.003) was a protective factor. ROC analysis showed that the areas under the ROC curve of PLT and sIL-2R predicting BMI in ML patients was 0.712 (95%CI: 0.646-0.776, P<0.001) and 0.796 (95%CI: 0.739-0.853, P<0.001), respectively. The best cut-off point of PLT and sIL-2R was 160×109/L and 2 568 U/ml, respectively. The diagnostic specificities of the two indexes here were both greater than 80%.
Conclusion: PLT and sIL2R show good diagnostic value for ML patients with BMI.
题目: 实验室指标对恶性淋巴瘤患者骨髓浸润的预测价值分析.
目的: 分析恶性淋巴瘤（ML）患者骨髓浸润（BMI）对实验室检测指标的影响，并评估可用于预测/诊断BMI的实验室标志物.
方法: 回顾性分析137例ML患者的临床特征和实验室指标检测结果，研究ML患者合并BMI对实验室指标的影响，使用逻辑回归分析和受试者工作曲线（ROC）评估ML患者BMI的独立危险因素和预测变量的诊断价值.
结果: 与非BMI组相比，BMI组的红细胞分布宽度、C反应蛋白、血沉、D-二聚体、乳酸脱氢酶、碱性磷酸酶、β2-微球蛋白、转铁蛋白、CA153、CA125、可溶性白介素2受体（sIL-2R）水平均升高，而血小板计数（PLT）降低，差异具有统计学意义（P＜0.05）。多因素Logistic回归分析校正了与BMI相关的血液指标以及单因素回归分析结果中有意义的指标，结果显示，T细胞相关的非霍奇金淋巴瘤（调整后OR=2.18，95%CI：1.48-4.90，P＜0.001）、临床分期Ⅲ-Ⅳ（调整后OR=3.32，95%CI：2.16-5.83，P＜0.001）、sIL-2R（调整后OR=4.26，95%CI：2.95-12.85，P＜0.001）为ML患者合并BMI的危险因素，而PLT（调整后OR=0.89，95%CI：0.55-0.96，P=0.003）为保护因素。ROC分析结果显示，PLT和sIL-2R预测ML患者BMI的ROC曲线下面积分别为0.712（95%CI：0.646-0.776，P<0.001）和0.796（95%CI：0.739-0.853，P<0.001），PLT和sIL-2R的最佳切点分别为160×109/L和2 568 U/ml，此处两个指标的诊断特异度均＞80.
结论: PLT、sIL-2R对ML患者合并BMI的诊断具有较好的预测价值.