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软骨肉瘤中 IDH 突变的预后意义:一项个体患者数据荟萃分析。

Prognostic importance of IDH mutations in chondrosarcoma: An individual patient data meta-analysis.

机构信息

Department of Pathology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA.

Stephenson Cancer Center, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA.

出版信息

Cancer Med. 2021 Jul;10(13):4415-4423. doi: 10.1002/cam4.4019. Epub 2021 Jun 3.

Abstract

INTRODUCTION

IDH1/2 mutations are prevalent in cartilaginous tumors including chondrosarcoma. This meta-analysis using individual patient data (IPD) aimed to investigate the clinical and prognostic association of these mutations in chondrosarcoma patients.

METHODS

Two electronic databases including PubMed and Web of Science were searched for relevant data. We included studies providing IPD of chondrosarcoma with available IDH1/2 mutational status for meta-analysis. Chi-square and t-test were performed to compare the groups with and without IDH1/2 mutations. For survival analysis, log-rank test, and Cox proportional hazards model were used to investigate the association of IDH mutations with patient outcomes.

RESULTS

Fourteen studies with 488 patients were analyzed. IDH1 and IDH2 mutations were detected in 38.7% and 12.1% of cases, respectively. IDH1/2 mutations were significantly associated with an older age (p = 0.003), tumor origins (p < 0.001), tumor grades (p < 0.001), larger diameter (p = 0.003), relapse (p = 0.014), and patient mortality (p = 0.04). Multivariate Cox regression analysis adjusted for age, gender, tumor grade, and tumor sites confirmed the negative impact of IDH1/2 mutations on patient overall survival (HR = 1.90; 95% CI = 1.06-3.42; p = 0.03).

CONCLUSION

Our meta-analysis demonstrated the distinct characteristics of IDH1/2-mutated chondrosarcomas in comparison to those without mutations. These mutations could serve as an independent prognostic biomarker to better prognosticate patient outcomes and design appropriate treatment plans.

摘要

简介

IDH1/2 突变在包括软骨肉瘤在内的软骨肿瘤中较为常见。本项使用个体患者数据(IPD)的荟萃分析旨在研究这些突变在软骨肉瘤患者中的临床和预后相关性。

方法

我们在 PubMed 和 Web of Science 两个电子数据库中搜索了相关数据。我们纳入了提供了可用于荟萃分析的软骨肉瘤患者 IPD 且存在 IDH1/2 突变状态的研究。使用卡方检验和 t 检验比较有和无 IDH1/2 突变的组。对于生存分析,使用对数秩检验和 Cox 比例风险模型来研究 IDH 突变与患者结局的关系。

结果

共分析了 14 项包含 488 例患者的研究。IDH1 和 IDH2 突变分别在 38.7%和 12.1%的病例中被检测到。IDH1/2 突变与年龄较大(p=0.003)、肿瘤起源(p<0.001)、肿瘤分级(p<0.001)、更大的直径(p=0.003)、复发(p=0.014)和患者死亡率(p=0.04)显著相关。经年龄、性别、肿瘤分级和肿瘤部位调整的多变量 Cox 回归分析证实,IDH1/2 突变对患者总体生存有负面影响(HR=1.90;95%CI=1.06-3.42;p=0.03)。

结论

我们的荟萃分析表明,与无突变的软骨肉瘤相比,IDH1/2 突变的软骨肉瘤具有明显不同的特征。这些突变可以作为一个独立的预后生物标志物,以更好地预测患者结局并制定适当的治疗计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26bb/8267117/59837ebe7d9c/CAM4-10-4415-g003.jpg

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