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目的：探讨血清可溶性白细胞介素-2受体（sCD25）、胰岛素样生长因子-I（IGF-I）水平与初诊多发性骨髓瘤（MM）患者免疫表型及疗效的关系。方法：选取2023年1月-2024年6月在天门市第一人民医院接受诊治的125例初诊MM患者（MM组），另选取同期我院体检健康的70例健康体检者（对照组）。比较不同分期初诊MM患者血清sCD25、IGF-I水平，根据治疗疗效将初诊MM患者分为缓解组（76例）和未缓解组（49例），比较缓解组和未缓解组血清sCD25、IGF-I水平。根据血清sCD25、IGF-I水平的中位值分为高sCD25组和低sCD25组、高IGF-I组和低IGF-I组，分析高sCD25组和低sCD25组、高IGF-I组和低IGF-I组免疫表型差异。受试者工作特征（ROC）曲线分析血清sCD25、IGF-I对初诊MM患者疗效的评估价值。多因素Logistic回归分析初诊MM患者疗效的影响因素。结果：对照组血清sCD25、IGF-I水平显著低于MM组（P<0.05）。不同分期初诊MM患者血清sCD25、IGF-I水平差异有统计学意义（P<0.05）。Ⅲ期初诊MM患者血清sCD25、IGF-I水平显著高于Ⅰ期和Ⅱ期初诊患者（P<0.05），且Ⅱ期高于Ⅰ期（P<0.05）。高sCD25组CD56阳性表达率高于低sCD25组；两组CD117和CD200阳性表达率比较，差异不显著（P＞0.05）。高IGF-I组CD56和CD117阳性表达率高于低IGF-I组（P＜0.05），两组CD200阳性表达率比较，差异不显著（P＞0.05）。缓解组血清sCD25、IGF-I水平显著低于未缓解组（P<0.05）。ROC曲线分析显示，血清sCD25、IGF-I单独及联合检测评估初诊MM患者疗效的曲线下面积（AUC）为0.748、0.775、0.832，且联合检测的AUC大于各指标单独检测。多因素Logistic回归模型结果显示，血清sCD25水平升高、血清IGF-I水平升高、MM分期III期是影响初诊MM患者疗效的独立危险因素（P<0.05）。结论：血清sCD25、IGF - I水平与初诊MM患者疾病分期、治疗疗效密切相关，联合检测对疗效有较高评估价值，可作为影响疗效的重要评估指标。

英文摘要:

Objective: To investigate the relationship between serum soluble interleukin-2 receptor (sCD25) and insulin-like growth factor-I (IGF-I) and the immunophenotype and therapeutic efficacy of newly diagnosed multiple myeloma (MM) patients. Method: 125 newly diagnosed MM patients (MM group) who received treatment at Tianmen First People''s Hospital from January 2023 to June 2024 were selected, and another 70 healthy individuals who underwent physical examinations at our hospital during the same period were selected (control group). The serum sCD25 and IGF-I levels in newly diagnosed MM patients of different stages were compared, and newly diagnosed MM patients were divide into remission group (76 cases) and non remission group (49 cases) based on treatment efficacy, the serum sCD25 and IGF-I levels between the remission group and non remission group were compared. The patients were divided into high sCD25 group and low sCD25 group, high IGF-I group and low IGF-I group according to the median levels of serum sCD25 and IGF-I, the immunophenotypic differences between high sCD25 group and low sCD25 group, as well as high IGF-I group and low IGF-I group were analyzed. Serum sCD25 and IGF-I for evaluating the efficacy of newly diagnosed MM patients were analyzed by receiver operating characteristic (ROC) curve. Factors affecting the therapeutic effect of newly diagnosed MM patients were analyzed by multivariate logistic regression analysis. Result: Serum sCD25 and IGF-I levels in the control group were significantly lower than those in the MM group (P<0.05). There was a statistically significant difference in serum sCD25 and IGF-I levels among newly diagnosed MM patients at different stages (P<0.05). Serum sCD25 and IGF-I levels in stage III newly diagnosed MM patients were significantly higher than those in stage I and II (P<0.05), And stage II was higher than that in stage I(P<0.05). The positive expression rate of CD56 in the high sCD25 group was higher than that in the low sCD25 group, there was no significant difference in the positive expression rates of CD117 and CD200 between the two groups (P>0.05). The positive expression rates of CD56 and CD117 in the high IGF-I group were higher than those in the low IGF-I group (P<0.05), and there was no significant difference in the positive expression rate of CD200 between the two groups (P>0.05). Serum sCD25 and IGF-I levels in the remission group were significantly lower than those in the non remission group (P<0.05). ROC curve analysis showed that, the area under the curve (AUC) for evaluating the efficacy of newly diagnosed MM patients using serum sCD25 and IGF-I detection alone and in combination were 0.748, 0.775 and 0.832, respectively, and the AUC for combined detection was greater than that for each indicator detected separately.The results of multivariate Logistic regression model showed that elevated serum sCD25 level, elevated serum IGF-I level and MM stage III were independent risk factors affecting the efficacy of newly diagnosed MM patients (P<0.05).Conclusion:Serum sCD25 and IGF-I levels are closely related to the disease stage and therapeutic efficacy of newly diagnosed MM patients.Combined detection has a high evaluation value for efficacy and can be used as an important evaluation index affecting efficacy.

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