| Objective:To investigate evaluative value of serum sialic acid(SA)in different types of multiple myeloma(MM).Methods:We reviewed the data from 175 patients who were admitted for MM in the affiliated Hospital of Qingdao University retrospectively.All the diagnosis and treatment were in accordance with the multiple myeloma treatment guideline of China(version 2020th).The patients with recent inflammatory,infectious diseases,diabetes,coronary heart disease,liver cirrhosis,nephrotic syndrome,uremia,rheumatic immune diseases,malignant tumors or uncontrolled blood pressure were excluded.Moreover,we applied the multiple myeloma treatment guideline of China(version 2020th)to divide the therapeutic effect of patients into complete remission,very good partial remission,partial remission and disease recurrence.By the time of last follow-up visit ended in June 8,2020,the overall survival time progression-free survival time of the patients were recorded.At the same time,randomly selected 50 healthy people without basic diseases in the hospital(from January1,2019 to October 31,2019)as the healthy control group.We used SPSS 22.0 software to analyze the data of patients with MM,including clinical features,laboratory results and prognosis.Results:1.Serum sialic acid failed to reach statistical significance between patients over 60 years of age,and under 60 years,so as between male and female patients.indicating that the level of sialic acid was not affected by age and sex(P > 0.05).Serum sialic acid failed to reach statistical significance among different DS stages and ISS stages,too.At the same time,the serum sialic acid of 175 patients with multiple myeloma and 50 healthy controls were compared.The serum sialic acid of patients with multiple myeloma was statistically higher than that of healthy controls(P<0.05).2.Level of serum sialic acid in IgA group and light chain group was significantly higher than the level of serum sialic acid in healthy group(P<0.05).However,the level of serum sialic acid in Ig G group failed to reach statistical significance when compared with healthy group(P> 0.05).Moreover,pairwise comparison revealed a statistically higher level of serum sialic acid in IgA group when compared to light chain group(P<0.05).3.There was no significant difference in levels of serum sialic acid among different chromosomal karyotypes and related genes in patients of IgA group and light chain group(P> 0.05).And independent sample t-test revealed extramedullary infiltration was not associated with the level of serum sialic acid(P> 0.05).4.The multiple linear regression model constructed by the laboratory indexes of patients with IgA and light chain multiple myeloma was statistically significant(IgA type:F=8.971,P<0.05;light chain type:F=15.593,P<0.05).In patients with two types of multiple myeloma,ESR and globulin had significant effects on sialic acid and were positively correlated with it(P<0.05).5.In IgA group and light chain group,the level of serum sialic acid decreased when the illness was in remission,and increased when in progression(P<0.05).6.For the prediction of patients of multiple myeloma from healthy people,ROC curve analysis showed the area under the curve(AUC)for serum sialic acid was 0.694,and the optimal cutoff value was 736.81.Kaplan-Meier survival analysis of high sialic acid group and low sialic acid group showed that high sialic acid group had shorter overall survival time(55.06 months [95%CI:46.29-63.72] vs 73.56 months [95% CI: 66.88-80.24];P<0.05)and progression-free survival time(22.63 months [95%CI:18.14-27.12] vs.39.01 months[95% CI: 32.95-45.08];P<0.05)in overall MM patients.7.Multivariate Cox proportional regression analysis revealed that the level of serum sialic acid was an independent prognostic factor of patients with light chain multiple myeloma.Among light chain patients,Kaplan-Meier survival analysis of high sialic acid group and low sialic acid group showed that the high sialic acid group had a shorter overall survival time(40.06 months [95%CI:25.59-54.54] vs 60.16 months [95% CI: 49.89-70.44];P<0.05)and progression-free survival time(16.96 months 95%CI:10.03-23.87] vs 34.07 months [95% CI: 27.00-41.14];P<0.05).Conclusion:1.Level of serum sialic acid in IgA group and light chain group was significantly higher than the level of serum sialic acid in healthy group,and the level of serum sialic acid in patients with IgA and light chain multiple myeloma was similar to that in healthy group.2.Serum sialic acid has predictive value for tumor burden in patients with IgA type multiple myeloma and light chain multiple myeloma.3.The level of serum sialic acid was an independent prognostic factor of patients with light chain multiple myeloma.Patients with high serum sialic acid at first diagnosis often have poor prognosis. |
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