SUDOSCAN: a tool for quick and effective evaluation of bortezomib-induced peripheral neuropathy
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摘要:
目的 本研究旨在探索SUDOSCAN检测（一种外周自主神经功能检测工具）对硼替佐米致周围神经病变（bortezomib-induced peripheral neuropathy，BIPN）的评估效果。 方法 以2021年7月至2022年10月首都医科大学附属北京朝阳医院血液科确诊的86例多发性骨髓瘤（multiple myeloma，MM）患者作为研究对象，另外选取30例无肿瘤史及化疗药物接触史的患者作对照，所有患者均接受了SUDOSCAN皮肤电导率（ESC值）检测，同时与总神经病变评分临床版（TNSc）、美国国立癌症研究所常见毒性分级标准（NCI-CTC）分级评分对比，并对试验组患者进行了评估所需时间比较。 结果 试验组患者手部、足部ESC值比对照组明显降低（手部：56.4 μs vs. 76.5 μs，P<0.001；足部：47.5 μs vs. 78.0 μs，P<0.001）；SODUSCAN 评估患者足部ESC值与TNSc评分呈显著负相关（r=−0.403，P<0.001）、与NCI-CTC等级无明显相关性(r=−0.227，P=0.051)；NCI-CTC等级与TNSc评分呈显著正相关(r=0.591，P<0.001)。SUDOSCAN检测所需中位评估时间与NCI-CTC等级相近（均为2.4 min），TNSc评分所需中位评估时间最长（13.4 min）。 结论 目前，BIPN缺乏准确、高效评估方式，SUDOSCAN检测简单易行，与TNSc评分呈显著负相关，且比TNSc评分用时更短，能够快速有效评估BIPN。 -
关键词:
- 硼替佐米致周围神经病变 /
- 化疗致周围神经病变 /
- 评估手段 /
- SUDOSCAN /
- 硼替佐米
Abstract:Objective To evaluate the use of SUDOSCAN, a peripheral autonomic nerve detection tool, for assessing bortezomib-induced peripheral neuropathy (BIPN). Methods Eighty-six patients with multiple myeloma (MM) from Beijing Chao-yang Hospital, Capital Medical University, between July 2021 and October 2022 were assessed. They received examination of electric skin conductivity (ESC) values with SUDOSCAN. These were compared with the Total Neuropathy Score clinical version (TNSc) and National Cancer Institute Common Toxicity Scale (NCI-CTC) grading. Another 30 patients with no history of tumors or chemotherapy drug exposure were included as controls. Results The ESC value for hands or feet in the experimental group was significantly lower than that of controls (hand: 56.4 μs vs. 76.5 μs, P<0.001; feet: 47.5 μs vs. 78.0 μs, P<0.001). The ESC value was negatively correlated with the TNSc score (r=-0.403, P<0.001); however, it had no significant correlation with the NCI-CTC grade (r=-0.227, P=0.051). There was a significant positive correlation between the NCI-CTC level and the TNSc score (r=0.591, P<0.001). The median evaluation time required by SUDOSCAN was similar to that of NCI-CTC grade (both were 2.4 minutes), and the median evaluation time required by the TNSc score was the longest (13.4 minutes). Conclusions There is no accurate and efficient assessment method for BIPN currently. SUDOSCAN is simple to use and has a significant negative correlation with TNSc scores together with a shorter time. Therefore, SUDOSCAN can evaluate BIPN quickly and effectively. -
表 1 试验组与对照组患者ESC值基本情况
项目 试验组（n=86） 对照组（n=30） Z P SUDOSCAN检测结果 0级 21（24.4） 30（100） — — 1级 29（33.7） — — — 2级 36（41.9） — — — 手ESC值（μs） 56.4（42.8～68.5） 76.5（68.0～84.0） −5.506 <0.001 足ESC值（μs） 47.5（22.0～66.0） 78.0（69.0～81.3） −5.706 <0.001 （）内单位为% 
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表 2 试验组与对照组手部、足部ESC值比较
组别 指标 ESC（μs） Z P 试验组 手平均ESC值 vs. 足平均ESC值 56.4（42.8～68.5） vs. 47.5（22.0～66.0） −2.711 0.007 左手ESC值 vs. 右手ESC值 57.6（43.8～72.0） vs. 55.9（42.8～70.5） −0.447 0.655 左足ESC值 vs. 右足ESC值 48.1（26.0～70.2） vs. 47.5（21.8～70.8） −0.196 0.845 对照组 手平均ESC值 vs. 足平均ESC值 76.5（68.0～84.0） vs. 78.0（69.0～81.3） −0.118 0.906 左手ESC值 vs. 右手ESC值 78.0（68.0～84.0） vs. 79.0（70.0～84.0） −0.321 0.748 左足ESC值 vs. 右足ESC值 78.0（69.0～82.0） vs. 79.0（71.0～83.0） −0.720 0.472
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表 3 3种评估方式结果相关性分析
项目 r P NCI-CTC等级与TNSc 0.591 <0.001 手ESC值与NCI-CTC等级 −0.045 0.704 足ESC值与NCI-CTC等级 −0.227 0.051 手ESC值与TNSc −0.240 0.040 足ESC值与TNSc −0.403 <0.001
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