The relationship between serum CST6,IL-17A and the severity and prognosis of multiple myeloma bone disease

Zhao Sijie; LiI Miaojing; Chen Yuling; He Yangxin; Wang Xiaoning

doi:10.3969/j.issn.1671-6450.2023.12.014

Abstract：Objective To study the serum levels of cysteine protease inhibitor 6(CST6)and interleukin-17A(IL-17A)in patients with multiple myeloma bone disease(MMBD)and their relationship with the severity and prognosis of MMBD.Methods Eighty patients with MMBD diagnosed and treated in the Hematology Department of the First Affiliated Hospital of Xi'an Jiaotong University from February 2019 to January 2020 were selected as the MMBD group,and 50 pa-tients with multiple myeloma without bone disease diagnosed and treated during the same period were selected as the con-trol group.Enzyme linked immunosorbent assay was used to detect serum levels of CST6 and IL-17A;The correlation was analyzed using Spearman rank correlation analysis;The evaluation value of serum CST6 and IL-17A on the prognosis of MMBD by analyzing the working characteristic curve of subjects;Multivariate Cox regression analysis of factors affecting the prognosis of MMBD patients;Kaplan Meier survival analysis of the impact of serum CST6 and IL-17A levels on the prognosis of MMBD patients.Results Compared with the control group,the serum CST6 level in the MMBD group de-creased and the serum IL-17A level increased significantly(t/P=39.798/＜0.001,18241/＜0.001).Serum CST6 was significant-ly negatively correlated with MMBD bone disease grading,while serum IL-17A was significantly positively correlated with MMBD bone disease grading(r/P=-0.721/＜0.001,0.664/＜0.001);The area under the curve(AUC)of serum CST6,IL-17A,and their combination for evaluating the prognosis of MMBP patients were 0.812,0.888,and 0.931,respectively.The combination of the two had the highest AUC for evaluating the prognosis of MMBP patients(Z/P=5.147/＜0.001,4.784/＜0.001);The 3-year cumulative survival rate of the CST6 low expression subgroup is lower than that of the CST6 high expres-sion subgroup(x2=7.933,P=0.005),the 3-year cumulative survival rate of the IL-17A high expression subgroup was lower than that of the IL-17A low expression subgroup(x2=22.802,P＜0.001);ISS stage Ⅲ,bone disease grade 4,and high ser-um IL-17A are independent risk factors affecting the prognosis of MMBD patients.High serum CST6 is an independent protective factor affecting the prognosis of MMBD patients[OR(95％CI)=1.594(1252-2.028),1.589(1258-2.006),1.451(1.120-1.879),0.703(0.537-0.919)].Conclusion The decrease of serum CST6 and the increase of IL-17A levels in MMBD patients are independent factors affecting the prognosis of MMBD patients,which are related to the severity of their condi-tion.