Abstract:

Objective To investigate the roles of serum ferritin （SF）,vitamin B₁₂（Vit B₁₂）and folic acid（FA）in the auxiliary diagnosis and prognosis evaluation of 3 subtypes of myelodysplastic syndrome（MDS）[refractory anemia（RA）,refractory anemia with excess blasts（RAEB）-Ⅰ and RAEB-Ⅱ]. Methods A total of 55 MDS patients（13 cases of RA,18 cases of RAEB-Ⅰ and 24 cases of RAEB-Ⅱ） and 50 healthy subjects（healthy control group） were enrolled,and the levels of SF, Vit B₁₂ and FA were determined. The 55 MDS patients were classified into relatively low risk group（25 cases）and relatively high risk group （30 cases）according to the International Prognostic Scoring System （IPSS）. Receiver operating characteristic（ROC）curve was used to evaluate the roles of SF,Vit B₁₂ and FA in assessing the risk of MDS. The roles of SF,Vit B₁₂ and FA for prognosis was evaluated by Kaplan-Meier survival curve. Results The levels of SF,Vit B₁₂ and FA in the 3 subtypes of MDS group were higher than those in healthy control group （P<0.01）,especially for RAEB- Ⅱ patients. The levels of SF,Vit B₁₂ and FA in relatively high risk group were higher than those in relatively low risk group （P<0.01）. ROC curve analysis showed that the areas under curve（AUC） of single determinations of SF,Vit B₁₂ and FA for distinguishing MDS patients with low risk from high risk were 0.749,0.791 and 0.811,respectively. The optimal cut-off values of SF,Vit B₁₂ and FA were 425.77 ng/mL,940.77 pg/mL and 18.28 ng/mL,respectively. The AUC of the combined determination was 0.907. The median survival time of good prognosis group was longer than that of poor prognosis group （P<0.01）,when FA+Vit B₁₂+SF （SF>425.77 ng/mL,Vit B₁₂>940.77 pg/mL and FA>18.28 ng/mL） was used to predict prognosis. Conclusions The single determinations of SF,Vit B₁₂ and FA have auxiliary diagnostic value for the 3 subtypes of MDS. The combined determination of SF,Vit B₁₂ and FA plays a role in the prognosis evaluation of MDS.

Key words: Ferritin, Vitamin B₁₂, Folic acid, Myelodysplastic syndrome