Lussana Federico, Caberlon Sabrina, Pagani Chiara, Kamphuisen Pieter W, Büller Harry R, Cattaneo Marco
Divisione di Medicina Generale III, Azienda Ospedaliera San Paolo Dipartimento di Medicina, Chirurgia e Odontoiatria, Università di Milano, Via A. di Rudinì 8, Milan, Italy.
Thromb Res. 2009 Sep;124(4):409-17. doi: 10.1016/j.thromres.2009.02.004. Epub 2009 Mar 18.
Many studies evaluated the association of V617F Jak-2 with the risk of thrombosis in patients with essential thrombocythaemia, but the results of these studies were inconsistent. Few studies evaluated the association of V617F Jak-2 mutation with the risk of thrombosis in patients with idiopathic myelofibrosis. Therefore, we performed a systematic review of the studies that assessed the risk of thrombosis associated with V617F Jak-2 in patients with ET or IM.
We searched MEDLINE and EMBASE databases and reference lists of retrieved articles. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated for each trial and pooled.
We included 21 studies involving patients with essential thrombocythaemia and 6 studies patients with idiopathic myelofibrosis. In essential thrombocythaemia patients, V617F Jak-2 was associated with a significant increased risk of thrombosis (OR 1.92, 95% CI 1.45-2.53), both of venous (OR 2.49, 95% CI 1.71-3.61) and arterial (OR 1.77, 95% CI 1.29-2.43) vessels. In idiopathic myelofibrosis patients, the risk of thrombosis associated with V617F Jak-2 tended to be increased (OR 1.76, 95% CI 0.91-3.41).
Our systematic review suggests that V617F Jak-2 increases the risk of thrombosis in essential thrombocythaemia patients by about two fold while its role in idiopathic myelofibrosis patients is uncertain.
许多研究评估了V617F Jak-2与原发性血小板增多症患者血栓形成风险之间的关联,但这些研究结果并不一致。很少有研究评估V617F Jak-2突变与原发性骨髓纤维化患者血栓形成风险之间的关联。因此,我们对评估原发性血小板增多症(ET)或原发性骨髓纤维化(IM)患者中与V617F Jak-2相关的血栓形成风险的研究进行了系统评价。
我们检索了MEDLINE和EMBASE数据库以及检索文章的参考文献列表。计算每个试验的比值比(OR)和95%置信区间(CI)并进行汇总。
我们纳入了21项涉及原发性血小板增多症患者的研究和6项涉及原发性骨髓纤维化患者的研究。在原发性血小板增多症患者中,V617F Jak-2与静脉(OR 2.49,95%CI 1.71-3.61)和动脉(OR 1.77,95%CI 1.29-2.43)血管血栓形成风险显著增加相关。在原发性骨髓纤维化患者中,与V617F Jak-2相关的血栓形成风险有增加趋势(OR 1.76,95%CI 0.91-3.41)。
我们的系统评价表明,V617F Jak-2使原发性血小板增多症患者的血栓形成风险增加约两倍,而其在原发性骨髓纤维化患者中的作用尚不确定。