不同预后积分系统在骨髓增生异常综合征预后评估中的对比

Comparative study on different prognostic scoring system in prognosis evaluation of myelodysplastic syndrome

目的研究不同积分系统在骨髓增生异常综合征（myelodysplastic syndrome,MDS）患者预后评估中的差异性,指导临床精确预后分层和个体化治疗。方法回顾性分析72例初治MDS患者的临床资料,根据国际预后积分系统（international prostate symptom score,IPSS）、世界卫生组织分型预后积分系统（World Health Organization classification-based prognostic scoring system,WPSS）及国际预后积分系统修订版（revised international prognostic scoring system,IPSS-R）进行预后评估。结果各预后积分系统不同分层中位生存期进行比较,差异均有统计学意义（Tarone-Ware为9.572-19.834,P〈0.05）。WPSS生存曲线各组相交多,IPSS-R生存曲线各组交叉少,IPSS、WPSS对低危组预后评估不佳,IPSS-R最佳。IPSS与IPSS-R相关性最强（rs=0.765,P〈0.05）。结论 IPSS、WPSS、IPSS-R对初治MDS患者的预后评估均有意义,其中IPSS-R最具优势,临床工作中联合利用3种系统更有利于MDS预后评估。

Objective To explore the significance among different scoring systems in predicting the prognosis of myelodysplastic syndrome （MDS）, to guide the clinical accurate prognosis stratification and personal treatment. Methods The clinical data of 72 patients with newly diagnosed MDS were retrospectively reviewed, the prognosis was evaluated according to international prostate symptom score （IPSS）, World Health Organization classificatlon-based prognostic scoring system （WPSS） and revised international prognostic scoring system （IPSS-R）. Results The difference of median survival time between different groups of prognostic scoring system was statistically significant （Tarone-Ware=9.572-19.834, P〈0.05）. The survival curve of WPSS had more intersections between each group, IPSS-t/prognosis had less intersections. For low risk group, prognostic evaluation of IPSS and WPSS were poor, IPSS-R was the best way to predict the prognosis. Correlation between IPSS and IPSS-1R was the strongest （r1=0.765, P〈0.05）. Conclusions All the three scoring systems can better predict the prognosis of patients with newly diagnosed MDS, and IPSS-tl has more advantages. Integrated using 3 scoring system in clinical work is more favorable for clinical prognosis evaluation of MDS.