文档介绍：真性红细胞增多症常用诊断标准的比较
真性红细胞增多症常用诊断标准比较
张旻昱;胡延平;陈芳;张男;王覘秀;崔丽芬;张振忠;姜若腾;李月明;张继红
【摘要】目的：本文描述了 3种真性红细胞增多症诊断标准：国内诊断标准、WH02008年诊断标准和BCSH诊断标准，并比较3种诊断标准的敏感性及特异性。
方法：通过统计50例近期在中国医科大学附属盛京医院就诊的以红细胞增多为主要临床表现的病例自就诊以来相关信息，根据病史及临床疗效将患者分组，将此结果与3种诊断标准得出的结果进行对比。
结果：在纳入分析范围的45例患者中，将35例诊断为PV,其余10 例为继发性红细胞增多。将国内诊断标准、WHO诊断标准及BCSH诊断标准分别与临床诊断结果对比，%、 %和 %,特异性分别为 100%> 70%和 90%。结论：JAK2V617F 基因突变在PV诊断中有重要地位。在JAK2V617F基因突变阴性的情况下， BCSH诊断标准较为精准；而当JAK2V617F基因突变阳性时，单纯依靠BCSH 诊断标准会造成敏感性降低，需要WHO诊断标准作为补充。
【关键词】真性红细胞增多症;诊断标准;WHO;BCSH
【中图分类号】
[Abstract]Objective:Three sets of diagnostic criteria for polycythaemia vera (PV): the National diagnostic criteria,the British Committee for Standards in Haematology (BCSH) criteria and the World Health Organisation(WHO) criteria(2008) have been compared the ability of each set of criteria to accurately diagnose PV and differentiate it from secondary erythrocytosis. Methods:The clinical database was drawn from erythrocytosis patients currently attending the Shengjing Hospital of China Medical University and the relevant information from the time of diagnosis for each patient was assessed according to each set of criteria.
Result:Sufficient data was available on 45 patients: 35 PV and 10 secondary erythrocytosis according to the clinical diagnosis. The National diagnostic criteria classified only 18 of 35 patients(%) as PV because of its WHO criteria had a sensitivity of % for classifying PV,while the BCSH criteria had an acceptable level of %. For secondary
erythrocytosis, the specificity of the National diagnostic criteria, the WHO criteria and the BCSH criteria are 100%,70% and 90% respectively.
Conclusion:We concluded that the Janus kinase 2 (JAK2)V617F mutation was a sign讦icant factor in the diagnosis of PV,and two different diagnostic criterias should be taken on the basis of JAK2V617F BCSH criteria were the most accurate diagnostic criteria for PV in the n