Objective: To establish a prognostic nomogram based on response to bortezomib and BTK expression for treatment-experienced multiple myeloma patients.
Methods: The Oncomine database was utilized to determine BTK expression, sex, age, albumin, Mayo index, response to bortezomib treatment, follow-up time and survival status in multiple myeloma(MM) patients. Cut-off point for BTK expression was calculated using R software. Univariate and multivariate analyses by Cox proportional hazards regression were then performed. Significant prognostic factors were combined to build a nomogram. The discrimination ability and predictive accuracy of the nomogram were evaluated using the index of concordance (C-index) and calibration curves.
Results: Multivariate analysis showed that response to bortezomib, BTK expression and sex were independent risk factors for prognosis. The C-index value of the nomogram made according to the independent risk factors was 0.729 (95%CI, 0.642-0.8164). The calibration curves showed good consistency between predicted and actual survivals for 1-year and 2-year overall survival.
Conclusion: The proposed nomogram is accurate in predicting the prognosis of patients with MM.
题目: 基于硼替佐米治疗反应及BTK表达水平建立非初治多发性骨髓瘤临床预测模型.
目的: 基于硼替佐米治疗反应及骨髓瘤细胞BTK表达水平建立非初治多发性骨髓瘤（MM）临床预测模型的列线图（nomogram）。.
方法: 运用Oncomine数据库搜索BTK基因表达水平、性别、年龄、白蛋白水平、Mayo评分、硼替佐米治疗反应、随访时间及生存状态等信息，计算影响MM临床预后的BTK表达水平截断值（cut-off值），对上述因素进行Cox多因素回归分析，并根据独立预后因素制作列线图，用一致性指数（C-index）和校正曲线确定列线图的预测精度和判别能力。.
结果: 多因素分析结果显示，影响患者预后的因素有硼替佐米治疗反应、BTK表达水平及性别，根据上述指标制作的列线图一致性指数为0.729（95%CI，0.642-0.8164），患者1年及2年的生存率的校正曲线与实际观测结果吻合较好。.
结论: 基于BTK表达水平及硼替佐米治疗反应的列线图能准确地预测MM患者的预后。.
Keywords: BTK; Oncomine database; clinical predictive model; multiple myeloma; nomogram.