目的 探究多发性骨髓瘤(MM)患者血清成纤维细胞生长因子受体 2(FGFR2)、细胞通信网络因子 1(CCN1)表达与 预后的相关性。 方法 选取 2020 年 9 月至 2022 年 1 月在河北中石油中心医院接受治疗的 104 例初诊 MM 患者为研究组,并以 在河北中石油中心医院通过健康体检测试的同期同年龄段的 106 例健康人作为对照组。 根据预后随访结果,将研究组患者分 为生存组 62 例,死亡组 42 例。 ELISA 法检测患者血清 FGFR2、CCN1 水平;Spearman 分析血清 FGFR2、CCN1 水平与患者国际 分期系统(ISS)分期的相关性;MM 患者死亡的风险因素则通过多因素 Cox 比例风险回归模型分析;受试者操作特征(ROC)曲 线分析血清 FGFR2、CCN1 水平对 MM 患者死亡的诊断价值;Kaplan-Meier 法分析血清 FGFR2、CCN1 水平与 MM 患者 3 年生 存率的关系。 结果 相较于对照组,研究组患者血清 FGFR2 水平显著提高,CCN1 水平显著降低(P<0. 05);与生存组相比,死 亡组患者血清 FGFR2 水平明显升高,CCN1 水平明显降低(P<0. 05);生存组、死亡组 ISS 分期比较,差异具有统计学意义(P< 0. 05);血清 FGFR2 水平与患者 ISS 分期呈正相关,血清 CCN1 水平与患者 ISS 分期呈负相关(P<0. 05);FGFR2、CCN1、ISS 分 期是 MM 患者死亡的独立风险因素(P<0. 05);血清 FGFR2、CCN1 水平联合诊断 MM 患者死亡的曲线下面积(AUC)为 0. 953; 联合诊断优于单独诊断(Z= 3. 513,3. 237,P<0. 05);血清 FGFR2 高表达患者 3 年生存率低于 FGFR2 低表达,血清 CCN1 低表 达患者 3 年生存率低于 CCN1 高表达(P<0. 05)。 结论 MM 患者血清 FGFR2 表达上调,CCN1 表达下调,与患者预后相关,二 者联合诊断 MM 患者死亡具有一定价值。

Objective To discuss the correlation between serum fibroblast growth factor receptor 2 FGFR2 cellular communication network 1 CCN1 and prognosis in patients with multiple myeloma MM . Method A total of 104 newly diagnosed MM patients who received treatment in Hebei PetroChina Central Hospital from September 2020 to January 2022 were selected as the study group and 106 healthy people of the same age who passed the health examination test in our hospital were selected as the control group. According to the follow-up results of prognosis patients in the study group were classified into a survival group of 62 cases and a death group of 42 cases. ELISA method was used to detect the serum FGFR2 and CCN1 in patients. Pearson analysis analyzed the correlation between serum FGFR2 and CCN1 levels and age and ISS stage of patients. The risk factors of death in MM patients were analyzed by multivariate Cox regression. ROC curves were used to analyze the diagnostic value of serum FGFR2 and CCN1 levels in the mortality of MM patients. The Kaplan-Meier method was used to analyze the relationship between serum FGFR2 and CCN1 levels and the three-year survival rate of MM patients. Result For the control group the study group had clearly higher serum FGFR2 and clearly higher CCN1 P< 0. 05 . For the survival group the death group had clearly higher serum FGFR2 and clearly higher CCN1 P< 0. 05 . The differences in age and ISS staging between the survival group and the death group were statistically clear P< 0. 05 . Serum FGFR2 level was positively correlated with ISS stage and serum CCN1 level was negatively correlated with ISS stage P< 0. 05 . FGFR2 CCN1 age and ISS stage were independent risk factors for mortality in patients with MM P<0. 05 . The joint of serum FGFR2 and CCN1 had an AUC of 0. 953 for diagnosing death in MM patients. The joint diagnosis was superior to individual diagnosis Z= 3. 513 3. 237 P< 0. 05 . The three-year survival rate of patients with high serum FGFR2 was lower than that of patients with low serum FGFR2 and the three-year survival rate of patients with low serum CCN1 was lower than that of patients with high serum CCN1 P < 0. 05 . Conclusion Serum FGFR2 is upregulated and CCN1 is downregulated in MM patients they are associated with prognosis. The joint of the two has certain value in diagnosing the death of MM patients.