The Study Of Correlation Between Vitamin D And ISS Staging Of Multiple Myeloma And TCM Syndromes

ObjectiveMultiple myeloma is the second largest tumor of the hematological system with a high heterogeneity.The responsiveness to treatment and the prognosis varies from patient to patient.With the advent of new drugs,the prognosis of patients with multiple myeloma has been significantly improved.But so far it is still incurable.Therefore,good prognosis assessment of patients is very important for treatment.ISS staging is theearliest assessment of the prognosis of multiple myeloma.Vitamin D deficiency is more common in patients with multiple myeloma.Studies on vitamin D and multiple myeloma have shown that vitamin D plays a role in the pathogenesis and treatment of multiple myeloma.It has been reported that vitamin D receptor polymorphism is associated with the pathogenesis of multiple myeloma.Vitamin D can inhibit the growth of multiple myeloma cells and induce apoptosisin a variety of ways.However,no pappers have reported the relationship between vitamin D and the prognosis of multiple myeloma.Chinese medicine considers that multiple myeloma is "bone erosion" category,and the basic pathogenesis is" Xie Sheng is virtual."Bothvitamin D and kidney essenceare essential substances for the maintenance of human health.According to the origin and the function of vitamins,it belongs to the category of kidney essence.In this experiment,we want to solve two problems.One is whether serum vitamin D level is related to the ISS staging of multiple myeloma,the other is whether serum vitamin D level is related to the TCM syndrome type of multiple myeloma.We hope that the experiment can be helpful to find a new way for the treatment of multiple myeloma.Serum vitamin D may be one of the prognostic indicators of multiple myeloma.Maintaining adequate vitamin D levels may reduce the incidence of multiple myeloma.For patients with multiple myeloma,maintaining adequate serum vitamin D levels may help improve patients’outcomes.MethodWe strictly follow the steps to conduct the experiment.In the experiment,patients must be meet the inclusion and discharge standards at the same time.We collected 30 cases of the patients who were suffered multiple myelomafrom May 2017 to January 2018 from hematology department of the first Affiliated Hospital of GuangzhouUniversity of Traditional Chinese Medicine.We also collected patient-related test data and divided the data into four sections.The first part is a routine examination,including blood routine,urine routine,stool routine,biochemical tests coagulation and imaging studies.Biochemical tests must include serum albumin and β 2 microglobulin。The second part is unique to patients with multiple myeloma,including serum protein electrophoresis,immunoelectrophoresis,humoral immunity.Patients will benefit from finishing the serum free light chain test,but the test will cost much.The third part is to improve the morphological examination,if it is necessary,please add the test of flow cytometry.The fourth part is the measurement of serum vitamin D levelsby taking blood In the early morning before they eat breakfast.At the same time,we collected patients’ four information of Traditional Chinese Medicine.Through careful dialectics,we divide the patients into liver and kidney yin deficiency,qi and blood deficiency,phlegm and blood stasis block three syndromes.The collected information will be tabulated and sorted.Then use SPSS 18.0 statistical software for data processing.For the data obtained by statistical software,we defined no significant difference when P>0.5;when P<0.5,the difference was statistically significant.In this way we wantto solvethree problems.First of all,to investigate the effect of age and gender onvitamin D in patients with multiple myeloma.Second,we need to find out whether serum albumin,β 2-microglobulin,ISS staging is related to vitamin D.Finally,we want to know if serum vitamin D levels are related to TCM syndromes.Result1.The vitamin D levels are below the ideal level up to 77.7%in the Patients of multiple myeloma.2.ISS staging of multiple myeloma was negatively correlated with serum vitamin D levels,with a correlation coefficient of-0.614.Namely,The higher the ISS stage is,the lower the level of serum vitamin D is.Among the patients with multiple myeloma in ISS stage Ⅲ,vitamin D of all the patients was less than the ideal level.The proportion was 83.33%in patients with ISS Ⅱ and 52.68%in patients with stage Ⅰ disease.β 2 microglobulin and serum vitamin D levels was negatively correlated,the correlation coefficient was-0.453,albumin and serum vitamin D was positively correlated with a correlation coefficient of 0.528.3.The vitamin D levels in liver andkidney yin deficiency,qi and blooddeficiency,phlegm and blood stasis block three syndromes of patients with multiple myeloma were not significantly different,P = 0.986.This means that the difference is not statistically significant.4.There was no significant correlation between age and sex and vitamin D levels in patients with multiple myeloma,because P>0.05.Their P values were 0.810 and 0.0.272,respectively.Conclusion1.Vitamin D below the ideal level is more common in patients with multiple myeloma.2.Serum vitamin D and multiple myeloma ISS staging is negatively correlated,that is,the lower the level of vitamin D is,the higher the staging is,the worse the prognosis of the patient is.Serum vitamin D and serum albumin levels were positively correlated.And Serum vitamin D levels were negatively correlated with β 2-microglobulin.3.There was no difference in the levels of vitamin D among liver andkidney yin deficiency,qi and blood deficiency,phlegm and blood stasis block three syndromes in patients with multiple myeloma.4.Age and gender are factors that affect serum vitamin D.But in multiple myeloma patients,age and gender had no effect on serum vitamin D levels.