Objective: To investigate the correlation of peripheral blood platelet/lymphocyte ratio (PLR) with Treg and Th17 and its influence on prognosis in newly diagnosed multiple myeloma (MM).
Methods: One hundred thirty-five newly diagnosed multiple myeloma patients admitted to the Department of Hematology of Zhengzhou People's Hospital from June 2015 to October 2022 were selected as MM group. Clinical data included sex, age, immune typing, ISS stage, blood calcium (Ca), albumin (ALB), hemoglobin (Hb), PLR, LDH, β2 microglobulin (β2-MG), Treg and Th17 levels. Sixty healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. PLR, Treg and Th17 levels in MM group and control group were compared. Pearson was used to analyze the correlation between PLR and Treg, Th17. The relationship between MM patients with different PLR and clinical features and prognosis was analyzed.
Results: The PLR and Th17 of MM patients were significantly higher than that of control group, and Treg was significantly lower than that of control group (P<0.05). In MM patients, PLR was negatively correlated with Treg (r=-0.616), and PLR was positively correlated with Th17 (r=0.555). Using mean PLR=132.72 as the boundary, 135 MM patients were divided into high PLR group (n=54) and low PLR group (n=81). In MM patients with high PLR, ISS stage, ALB and Treg were significantly higher than those in low PLR group, while Th17 was significantly lower than those in low PLR group (P<0.05). By univariate and COX regression analysis, PLR was an independent prognostic risk factor for newly diagnosed MM patients (P<0.05). MM patients with high PLR had better PFS and OS, and the difference was statistically significant compared with MM patients with low PLR (P<0.05). 65 patients admitted from June 2015 to December 2018 were used as the training set, and 70 patients admitted from January 2019 to October 2022 were used as the validation set. The OS of MM patients with different PLR were compared respectively. The results showed that the conclusions of the training set and the validation set were consistent. PLR with high expression had higher OS (P<0.01).
Conclusion: PLR is correlated with Treg and Th17 in newly diagnosed MM patients, and high PLR has better prognosis. PLR can be used to evaluate the prognosis of MM patients.
题目: 初诊多发性骨髓瘤外周血PLR与Treg、Th17的 相关性及对预后的影响.
目的: 探讨初诊多发性骨髓瘤（MM）外周血血小板/淋巴细胞比值（PLR）与调节性T细胞(Treg)、辅助性T细胞17(Th17)的相关性及对预后的影响.
方法: 本研究纳入郑州人民医院血液内科2015年6月至2022年10月收治的初诊MM患者135例作为MM组，收集临床资料，包括性别、年龄、免疫分型、ISS分期、血钙（Ca）、白蛋白（ALB）、血红蛋白（Hb）、PLR、LDH、β2微球蛋白（β2-MG）、Treg、Th17的水平。选取同期本院健康体检的健康志愿者60例作为对照组。比较MM组与对照组的PLR、Treg、Th17水平。运用Pearson分析PLR与Treg、Th17的相关性。分析不同PLR的MM患者与临床特征、预后的关系.
结果: MM患者的PLR、Th17均明显高于对照组，Treg的比例明显低于对照组（P<0.05）。MM患者PLR与Treg呈负相关性（r=-0.616），PLR与Th17呈正相关性（r=0.555）。以均值PLR=132.72为界，将135例MM患者分为高PLR组（n=54）和低PLR组（n=81），高PLR的MM患者ISS分期、ALB、Treg明显高于低PLR组，而Th17明显低于低PLR组（P<0.05）。经单因素和COX回归分析，PLR是初诊MM患者预后的独立危险因素（P<0.05）。高PLR的MM患者较低PLR的MM患者有更佳的PFS和OS，差异有统计学意义（P<0.05）。将2015年6月至2018年12月收治的65例患者MM作为训练集，将2019年1月至2022年10月收治的70 MM患者作为验证集，分别比较不同PLR的MM患者的OS，结果显示，训练集和验证集的结论保持一致，高表达的PLR具有更高的OS（P<0.01）.
结论: 初诊MM患者PLR与Treg、Th17存在相关性，高PLR者预后更好，PLR可用于评估MM预后.
Keywords: Th17; Treg; clinical features; newly diagnosed multiple myeloma; platelet/lymphocyte ratio; prognosis.