Objective: To investigate the clinical value of serum matrix metalloproteinase-13 (MMP-13) combined with β2-microglobulin (β2-MG) in the diagnosis and prognosis of multiple myeloma (MM). Methods: 76 cases of MM patients admitted to our hospital during the period from January 2013 to December 2016 were collected as the case group. During the same period, 60 cases of healthy examined people in our hospital were selected as the control group. According to the curative effect after treatment, the patients were divided into refractory group (34 cases) and remission group (42 cases). The inclusion criterion of refractory group was that the curative effect did not reach the partial response (PR) grade, and the inclusion criterion of remission group was that the curative effect reached PR and above. The serum levels of β2-MG and MMP-13 were detected by chemiluminescence and enzyme-linked immunosorbent assay (ELISA). MM patients were divided into high MMP-13 and low MMP-13 groups, high β2-MG and low β2-MG groups according to the median MMP-13 and β-2-MG levels. Results: The serum MMP-13 and β2-MG levels in the case group before chemotherapy were 59.6 pg·ml-1 and 8.3 mg·L-1, respectively. The levels of serum MMP-13 and β2-MG in the control group were 28.7 pg·ml-1 and 2.9 mg·L-1, respectively. The levels of serum MMP-13 and β2-MG in the case group were higher than those in the control group, and the difference was statistically significant (P<0.05). The levels of serum MMP-13 and β2-MG in the remission group after treatment were lower than those before treatment, and the difference was statistically significant (P<0.05). Before treatment and after treatment, the serum MMP-13 and β2-MG levels in the remission group were lower than those in the refractory group, and the difference was statistically significant (P<0.05). When combined with MMP-13 and β2-MG, the sensitivity and specificity to distinguish between the remission group and the refractory group was 79.7% and 92.8%, respectively. Compared with the low MMP-13 group, the survival time of patients in the high MMP-13 group was significantly lower (log-rank P=0.023). The survival time of the high β2-MG group was also significantly lower than that of the low β2-MG group (log-rank P=0.005).Conclusion: Detection of serum MMP-13 combined with β2-MG has an important clinical significance in the diagnosis and evaluation of MM prognosis. |
[1] 肖秋玲,代丽霞.DC-CIK联合BD方案对多发性骨髓瘤的疗效分析[J].现代医学,2018,46(4):417-420.
[2] 王加,王珏.免疫固定电泳联合轻链检测在多发性骨髓瘤中的临床应用[J].标记免疫分析与临床,2017,24(10):1088-1090.
[3] LEE D H,FRADLEY M G.Cardiovascular Complications of Multiple Myeloma Treatment:Evaluation,Management,and Prevention[J].Curr Treat Options Cardiovasc Med,2018,20(3):19.
[4] 单学赟,孙乃同,王纯斌.微小RNA与多发性骨髓瘤诊治的研究进展[J].现代医学,2017,45(9):1380-1383.
[5] TERPOS E,NTANASIS-STATHOPOULOS I,GAVRIATOPOULOU M,et al.Pathogenesis of bone disease in multiple myeloma:from bench to bedside[J].Blood Cancer J,2018,8(1):7.
[6] 李清照,胡国瑜,沈婵娟,等.腺病毒介导CD269基因修饰树突状细胞体外治疗多发性骨髓瘤[J].现代医学,2017,45(10):1400-1404.
[7] 徐声鸣,沙辉,吕龙龙,等.多发性骨髓瘤患者血清lncRNA HOTAIR表达量与血清β-2微球蛋白及预后的相关性[J].中国实验诊断学,2018,22(2):191-196.
[8] 林果为.现代临床血液病学[M].上海:复旦大学出版社,2013.
[9] SCHRIBER J R,HARI P N,AHN K W,et al.Hispanics have the lowest stem cell transplant utilization rate for autologous hematopoietic cell transplantation for multiple myeloma in the United States:A CIBMTR report[J].Cancer,2017,123(16):3141-3149.
[10] MICHELS T C,PETERSEN K E.Multiple Myeloma:Diagnosis and Treatment[J].Am Fam Physician,2017,95(6):373-383.
[11] SAN-MIGUEL J F,HUNGRIA V T,YOON S S,et al.Panobinostat plus bortezomib and dexamethasone versus placebo plus bortezomib and dexamethasone in patients with relapsed or relapsed and refractory multiple myeloma:a multicentre,randomised,double-blind phase 3 trial[J].Lancet Oncol,2014,15(11):1195-1206.
[12] SHEIBANI S,MAHMOUDIAN R A,ABBASZADEGAN M R,et al.Expression analysis of matrix metalloproteinase-13 in human gastric cancer in the presence of Helicobacter Pylori infection[J].Cancer Biomark,2017,18(4):349-356.
[13] HIRA-MIYAZAWA M,NAKAMURA H,HIRAI M,et al.Regulation of programmed-death ligand in the human head and neck squamous cell carcinoma microenvironment is mediated through matrix metalloproteinase-mediated proteolytic cleavage[J].Int J Oncol,2018,52(2):379-388.
[14] GOKULNATH M,SWETHA R,THEJASWINI G,et al.Transforming growth factor-β1 regulation of ATF-3,c-Jun and JunB proteins for activation of matrix metalloproteinase-13 gene in human breast cancer cells[J].Int J Biol Macromol,2017,94(Pt A):370-377.
[15] KOTEPUI M,PUNSAWAD C,CHUPEERACH C,et al.Differential expression of matrix metalloproteinase-13 in association with invasion of breast cancer[J].Contemp Oncol (Pozn),2016,20(3):225-228.
[16] HU W,ZHANG W,LI F,et al.Bortezomib prevents the expression of MMP-13 and the degradation of collagen type 2 in human chondrocytes[J].Biochem Biophys Res Commun,2014,452(3):526-530.
[17] SUNDARA Y T,KOSTINE M,CLEVEN A H,et al.Increased PD-L1 and T-cell infiltration in the presence of HLA class I expression in metastatic high-grade osteosarcoma:a rationale for T-cell-based immunotherapy[J].Cancer Immunol Immunother,2017,66(1):119-128.
[18] MAZHER N,AHMAD N,IQBAL Z,et al.Correlation of Patterns of Bone Marrow Infiltration and Biochemical factors in Non-Hodgkin Lymphoma[J].Pak J Med Sci,2017,33(2):462-465. |