IL-6/STAT3信号通路在多发性骨髓瘤合并肺部感染中的表达及其对预后的评估价值

Expressions of IL-6/STAT3 signaling pathways in multiple myeloma patients complicated with pulmonary infection and values in assessment of prognosis

    摘要
  • 摘要:
    目的 分析白细胞介素-6(IL-6)/信号转导和转录激活因子3(STAT3)通路在多发性骨髓瘤合并肺部感染中的表达及其预后价值，为多发性骨髓瘤合并肺部感染患者的诊治提供参考。
    方法 回顾性选取2020年1月-2023年1月新疆石河子大学第一附属医院收治的120例多发性骨髓瘤合并肺部感染患者为感染组(n=120)，另选90例同期收治的多发性骨髓瘤无肺部感染患者为对照组(n=90)；比较两组外周血IL-6、STAT3 mRNA、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)及降钙素原(PCT)水平；采用临床肺部感染评分(CPIS)评估感染组肺部感染严重程度，分为轻度组(n=54)、中度组(n=36)及重度组(n=30)；比较轻度、中度及重度组患者IL-6、STAT3 mRNA水平；采用Pearson相关系数分析IL-6、STAT3 mRNA水平与多发性骨髓瘤合并肺部感染患者CPIS评分的相关性；出院后对感染组患者随访1年，以随访期间出现病情进展或死亡为预后不良，将患者分为预后良好组(n=92)与预后不良组(n=28)，比较预后良好组与预后不良组IL-6、STAT3 mRNA水平；绘制受试者工作特征(ROC)曲线分析IL-6、STAT3 mRNA水平对多发性骨髓瘤合并肺部感染患者预后不良的预测价值。
    结果 感染组外周血IL-6、STAT3 mRNA、TNF-α、CRP及PCT水平分别为(64.58±9.31)pg/ml、(2.12±0.33)、(84.41±11.29)pg/ml、(15.64±3.42)mg/L、(3.23±0.79)ng/ml，均高于对照组(均P < 0.05)；不同肺部感染严重程度患者IL-6、STAT3 mRNA水平比较，重度组>中度组>轻度组(均P < 0.05)；Pearson相关系数分析显示，IL-6、STAT3 mRNA水平与多发性骨髓瘤合并肺部感染患者CPIS评分均呈正相关(均P < 0.05)；预后不良组IL-6、STAT3 mRNA水平均高于预后良好组(均P < 0.05)；ROC曲线分析显示，IL-6、STAT3 mRNA水平及联合检测的曲线下面积(AUC)分别为0.886、0.890、0.965，联合检测优于单一检测(P < 0.05)。
    结论 多发性骨髓瘤合并肺部感染患者外周血IL-6、STAT3 mRNA升高，检测IL-6、STAT3 mRNA水平可辅助评估其肺部感染严重程度及预后。

     

    Abstract:
    OBJECTIVE To analyze the expression of interleukin-6 (IL-6)/signal transduction and transcriptional activator 3 (STAT3) pathway in multiple myeloma (MM)complicated with pulmonary infection and its prognostic value, and to provide references for the diagnosis and treatment for such disease.
    METHODS One hundred and twenty patients with MM complicated with lung infection admitted to the First Affiliated Hospital of Shihezi University in Xinjiang from Jan. 2020 to Jan. 2023 were retrospectively selected as the infected group (n=120), and 90 patients without lung infection admitted during the same period were selected as the control group (n=90). The levels of IL-6, STAT3 mRNA, tumor necrosis factor α (TNF-α), C-reactive protein (CRP) and procalcitonin (PCT) in peripheral blood of the two groups were compared. Based on clinical pulmonary infection score (CPIS), the infected patients were further divided into the mild (n=54), moderate (n=36) and severe group (n=30); IL-6 and STAT3 mRNA levels were compared among the three groups, their correlations with CPIS scores were analyzed by Pearson correlation. The infected group were followed up for 1 year after discharge and divided into the good (n=92) and poor prognosis group (n=28), and IL-6 and STAT3 mRNA levels were compared between the two groups. Receiver operating characteristics (ROC) curve analyzed the predictive values of IL-6 and STAT3mRNA levels.
    RESULTS IL-6, STAT3 mRNA, TNF-α, CRP and PCT levels in peripheral blood of the infected group were (64.58±9.31) pg/ml, (2.12±0.33), (84.41±11.29) pg/ml, (15.64±3.42) mg/L and (3.23±0.79) ng/ml, respectively, higher than those in the control group (all P < 0.05). The levels of IL-6 and STAT3 mRNA increased the highest in the severe group, followed by the moderate and mild group (all P < 0.05); they were positively correlated with CPIS scores (all P < 0.05) showed by Pearson correlation analysis; and they in the poor prognosis group were higher than those in the good prognosis group (all P < 0.05). IL-6 and STAT3 mRNA combined showed better predictive performance than their single detection (0.965, 0.886 and 0.890, respectively, P < 0.05).
    CONCLUSION The levels of IL-6 and STAT3mRNA in peripheral blood of patients with MM complicated with pulmonary infection are increased, and they can evaluate assistantly the severity of pulmonary infection and prognosis.

     

    • HTML全文
    • 参考文献(23)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回
下载中心