Wang Fangfang, Ni Jun, Wu Lei, Wang Ying, He Bin, Yu Duonan
Clinical Medical College, Yangzhou University, Yangzhou 225001, China.
Jiangsu Key Laboratory of Experimental & Translational Non-coding RNA Research, Yangzhou University School of Medicine, Yangzhou 225001, China.
J Cancer. 2019 Jan 30;10(5):1325-1332. doi: 10.7150/jca.28220. eCollection 2019.
Several prognostic scoring systems have been developed to assess prognosis in myelodysplastic syndrome (MDS). However, currently there are no systems that list gender as a prognostic factor. We queried a National Cancer Institute database to investigate the prognostic influence of gender on the survival of patients with MDS. We first identified 34,681 qualified patients diagnosed with MDS from 2001-2014 in the Surveillance, Epidemiology, and End Results (SEER) database, and then analyzed the characteristics of these patients using chi-squared tests. The Kaplan-Meier method and the multivariate Cox regression model were used to examine whether gender disparity in the survival of patients with MDS existed. We found that male patients had higher incidence rate of MDS (55.3% vs 44.7%, P<0.001) and a significant survival disadvantage (27.6% vs 33.6%, P<0.001) compared to female patients. Moreover, the less favorable survival rate of male MDS patients was associated with the age at diagnosis, race, marital status at diagnosis and the histological subtypes including refractory anemia (RA), refractory cytopenia with multilineage dysplasia (RCMD), myelodysplastic associated with isolated del 5q (MDS 5q-), myelodysplastic/myeloproliferative neoplasm (MDS/MPN) and not otherwise specified (NOS). In conclusion, gender can be considered as an independent prognostic factor for the overall survival of patients with MDS.
已经开发了几种预后评分系统来评估骨髓增生异常综合征（MDS）的预后。然而，目前尚无将性别列为预后因素的系统。我们查询了美国国立癌症研究所的数据库，以研究性别对MDS患者生存的预后影响。我们首先在监测、流行病学和最终结果（SEER）数据库中确定了2001年至2014年期间诊断为MDS的34681名合格患者，然后使用卡方检验分析了这些患者的特征。采用Kaplan-Meier法和多变量Cox回归模型来检验MDS患者生存中是否存在性别差异。我们发现，与女性患者相比，男性患者的MDS发病率更高（55.3%对44.7%，P<0.001），且生存存在显著劣势（27.6%对33.6%，P<0.001）。此外，男性MDS患者较差的生存率与诊断时的年龄、种族、诊断时的婚姻状况以及组织学亚型有关，包括难治性贫血（RA）、伴有多系发育异常的难治性血细胞减少症（RCMD）、与孤立性5q缺失相关的骨髓增生异常（MDS 5q-）、骨髓增生异常/骨髓增殖性肿瘤（MDS/MPN）和未另行指定（NOS）。总之，性别可被视为MDS患者总生存的独立预后因素。
