Abstract:

Objective To explore the relationship between serum type Ⅰ collagen carboxy-terminal peptide β-specific sequence(β-CTx), anti-tartrate acid phosphatase 5b isoenzyme(TRACP-5b) and the severity and prognosis of multiple myeloma bone disease(MMBD).Methods The clinical data of 142 patients with MMBD from Jan. 2016 to Jan. 2020 were retrospectively analyzed. When treatment guidelines and imaging examination were performed, the patients were divide into level Ⅰ group, level Ⅱ group, level Ⅲ group and level Ⅳ group according to disease severity. Enzyme-linked immunosorbent assay (ELISA) were used to detect serum levels of β-CTx and TRACP-5b of the patients. Spearman was used to analyze the correlation between serum β-CTx, TRACP-5b and severity of MMBD. All patients were divided into survival group and death group according to whether survived. Cox regression was used to analyze the related factors affecting prognosis.Results The serum β-CTx and TRACP-5b increased with severity grade in four groups(P<0.05). Spearman analysis showed that β-CTx and TRACP-5b levels were positively correlated with the severity of MMBD (r=0.753, 0.627, P<0.05). At the follow-up time, 98 cases were survival and 44 cases were death in 142 patients. The proportion of International Staging System(ISS) level Ⅲ, MMBD severity level Ⅳ, bone disease of pathological fracture, β2-MG, β-CTx and TRACP-5b levels were higher in death patients than in survival patients (P<0.05). The difference in survival curves of β-CTx/TRACP-5b of patients was statistically significant (P<0.05). Cox regression analysis showed that the risk factors for affecting prognosis in MMBD patients were β-CTx, TRACP-5b, β2-MG levels, ISS level Ⅲ, MMBD severity level Ⅳ, and bone disease of pathological fracture (P<0.05).Conclusion Serum β-CTx and TRACP-5b increase with the severity of MMBD, and both are the risk factors affecting prognosis of MMBD.

Key words: multiple myeloma, collagen type I, isoenzymes, prognosis