Comparison of diagnostic criteria for polycythaemia vera

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 described.We 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.Results: Sufficient data was available in 45 patients: 35 PV and 10 secondary erythrocytosis according to the clinical diagnosis.The National diagnostic criteria classified only 18 of 35 patients(51.43%) as PV because of its rigidity.The WHO criteria had a sensi tivity of 85.71% for classifying PV,while the BCSH criteria had an acceptable level of 91.43%.For secondary erythrocytosis,the specificity of the National diagnostic criteria,the WHO criteria and the BCSH criteria were 100%,70% and 90% respectively.Conclusion: We concluded that the Janus kinase 2(JAK2)V617F mutation was a significant factor in the diagnosis of PV,and two different diagnostic criterias should be taken on the basis of JAK2V617F mutation.The BCSH criteria was the most accurate diagnostic criteria for PV in the negative cases,yet Plts,Neuts and sEpo should be taken as a complementary to the BCSH and WHO criteria to differentiate between PV and other erythrocytoses when the JAK2V617F was positive.