多发性骨髓瘤患者特异骨代谢标志物的测定及临床应用
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摘要
目的了解特异骨代谢标志物骨钙素N端中分子(OCN-MID)、β-胶原特殊序列(β-CTx)在多发性骨髓瘤(MM)患者血清中的含量变化,探讨OCN-MID和β-CTx检测的临床应用价值。
方法选取2006年8月～2007年2月收治于甘肃省人民医院、兰州大学第二医院、兰州军区总医院的新诊断的MM患者34例,以34例性别和年龄相匹配的体检健康者作为对照组。检测其血清骨钙素N端中分子(OCN-MID)、β-胶原特殊序列(β-CTx)、甲状旁腺激素(PTH)、碱性磷酸酶(ALP)、钙(Ca)和磷(P)值。以ROC曲线分析OCN-MID和β-CTx的临床应用价值。
结果(1)与对照组比较,MM组血清OCN-MID明显低于对照组(P＜0.05),β-CTx含量高于对照组(P＜0.05),而血清Ca、P、PTH以及ALP差异无显著性(P＞0.05);(2)不同分期MM患者分析结果表明,分期越晚,OCN-MID水平越低,而β-CTx水平却升高。(3)ROC曲线显示OCN-MID和β-CTx灵敏度高、特异性好,ROC曲线下面积均大于0.9。
结论OCN-MID和β-CTx反映骨形成和骨吸收情况,该方法简便、快速、有效且特异性较高,可以帮助临床了解MM骨损害的程度和评价病情,具有十分良好的临床应用价值。
Objective To investigate the value variation of N-MID osteocalcin and 6-CrossLaps (β-CTx) in serum of patients with multiple myeloma (MM), and to explore their clinical significance.
Methods To collect 34 newly diagnosed multiple myeloma patients from Gansu province people's hospital, the second hospital of Lanzhou university and the general hospital of Lanzhou military area at the time from August 2006 to February 2007. Serum N-MID osteocalcin,β-CTx, alkaline phosphatase (ALP), calcium (Ca) and phosphonium (P) were measured in 34 MM patients and in 34 sex-age-matched controls.
Results Compared to control group , the content of N-MID osteocalcin was obviously lower in serum of MM group, while the content ofβ-CTx was much higher (P<0.05). The serum ALP,Ca,P concentrations were similar between MM patients and controls(P>0.05).By analysising the results of the MM patients in different stages, the later the stage was classified, the lower the level of N-MID osteocalcin was, but the level of serumβ-CTx was much higher. ROC curve demonstrated the detections of N-MID osteocalcin andβ-CTx had high sensitivity and specificity, and the area under the curve exceeded 0.9.
Conclusions N-MID andβ-CTx are brief, fast, valid bone metabolic markers to reflect bone formation and bone resorption. They can aid the clinical utility to comprehend the damage extent of patients with MM and to estimate pathogenetic condition. So they have important clinical value.
方法选取2006年8月～2007年2月收治于甘肃省人民医院、兰州大学第二医院、兰州军区总医院的新诊断的MM患者34例,以34例性别和年龄相匹配的体检健康者作为对照组。检测其血清骨钙素N端中分子(OCN-MID)、β-胶原特殊序列(β-CTx)、甲状旁腺激素(PTH)、碱性磷酸酶(ALP)、钙(Ca)和磷(P)值。以ROC曲线分析OCN-MID和β-CTx的临床应用价值。
结果(1)与对照组比较,MM组血清OCN-MID明显低于对照组(P＜0.05),β-CTx含量高于对照组(P＜0.05),而血清Ca、P、PTH以及ALP差异无显著性(P＞0.05);(2)不同分期MM患者分析结果表明,分期越晚,OCN-MID水平越低,而β-CTx水平却升高。(3)ROC曲线显示OCN-MID和β-CTx灵敏度高、特异性好,ROC曲线下面积均大于0.9。
结论OCN-MID和β-CTx反映骨形成和骨吸收情况,该方法简便、快速、有效且特异性较高,可以帮助临床了解MM骨损害的程度和评价病情,具有十分良好的临床应用价值。
Objective To investigate the value variation of N-MID osteocalcin and 6-CrossLaps (β-CTx) in serum of patients with multiple myeloma (MM), and to explore their clinical significance.
Methods To collect 34 newly diagnosed multiple myeloma patients from Gansu province people's hospital, the second hospital of Lanzhou university and the general hospital of Lanzhou military area at the time from August 2006 to February 2007. Serum N-MID osteocalcin,β-CTx, alkaline phosphatase (ALP), calcium (Ca) and phosphonium (P) were measured in 34 MM patients and in 34 sex-age-matched controls.
Results Compared to control group , the content of N-MID osteocalcin was obviously lower in serum of MM group, while the content ofβ-CTx was much higher (P<0.05). The serum ALP,Ca,P concentrations were similar between MM patients and controls(P>0.05).By analysising the results of the MM patients in different stages, the later the stage was classified, the lower the level of N-MID osteocalcin was, but the level of serumβ-CTx was much higher. ROC curve demonstrated the detections of N-MID osteocalcin andβ-CTx had high sensitivity and specificity, and the area under the curve exceeded 0.9.
Conclusions N-MID andβ-CTx are brief, fast, valid bone metabolic markers to reflect bone formation and bone resorption. They can aid the clinical utility to comprehend the damage extent of patients with MM and to estimate pathogenetic condition. So they have important clinical value.
引文
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