Department of Internal Medicine, Rochester General Hospital, NY, United States of America.
Department of Internal Medicine, Rochester General Hospital, NY, United States of America.
Thromb Res. 2022 Nov;219:14-21. doi: 10.1016/j.thromres.2022.08.029. Epub 2022 Sep 6.
Patients with malignancies including malignant gliomas have a relatively high risk for venous thromboembolism (VTE). Recent evidence has linked isocitrate dehydrogenase (IDH) mutation with reduced VTE risk in malignant glioma. This meta-analysis aims to quantify the association of IDH mutation status with risks of VTE in patients with glioma.
We searched PubMed, Google Scholar, Medline OVID, Cochrane library, Cumulative Index to Nursing and Allied Health Literature databases to identify relevant studies. The overall odd ratio (OR) was pooled using the random-effects model. We evaluated the statistical heterogeneity using Cochran's Q statistics and I tests. We performed subgroup analyses according to age, tumor, study design, and study quality.
A total of 2600 patients from 8 studies were included in the meta-analysis. Patients with IDH mutant-type gliomas had a significantly lower risk of VTE (OR: 0.21, 95 % confidence interval [CI]: 0.09-0.46, I2 = 34 %) compared to patients with IDH wild-type gliomas. Among high-grade (III and IV) glioma, VTE events in IDH-mutant gliomas occurred with an OR of 0.28 (95 % CI: 0.14-0.53). No statistically significant decrease in the VTE risk was observed in grade II gliomas with IDH mutation compared to IDH wild-type gliomas, as indicated by the OR of 0.60 (95 % CI: 0.17-2.11).
IDH mutation is significantly associated with 79 % lower risk of VTE among patients with high-grade glioma compared to IDH wild-type. Our findings suggest the potential utility of IDH mutation status regarding thromboprophylaxis, and the need for further studies to elucidate the mechanism of the association.
患有包括恶性胶质瘤在内的恶性肿瘤的患者发生静脉血栓栓塞症（VTE）的风险相对较高。最近的证据表明，异柠檬酸脱氢酶（IDH）突变与恶性胶质瘤患者的 VTE 风险降低有关。本荟萃分析旨在定量评估 IDH 突变状态与胶质瘤患者 VTE 风险的相关性。
我们检索了 PubMed、Google Scholar、Medline OVID、Cochrane 图书馆、护理学和联合健康文献累积索引数据库，以确定相关研究。使用随机效应模型汇总总体比值比（OR）。我们使用 Cochran's Q 统计量和 I 检验评估统计异质性。我们根据年龄、肿瘤、研究设计和研究质量进行了亚组分析。
共有 8 项研究的 2600 名患者纳入荟萃分析。与 IDH 野生型胶质瘤患者相比，IDH 突变型胶质瘤患者 VTE 的风险显著降低（OR：0.21，95%置信区间[CI]：0.09-0.46，I2=34%）。在高级别（III 级和 IV 级）胶质瘤中，IDH 突变型胶质瘤的 VTE 事件发生风险为 0.28（95%CI：0.14-0.53）。与 IDH 野生型胶质瘤相比，IDH 突变的 II 级胶质瘤患者的 VTE 风险未见统计学显著降低，OR 为 0.60（95%CI：0.17-2.11）。
与 IDH 野生型相比，IDH 突变与高级别胶质瘤患者 VTE 风险降低 79%显著相关。我们的研究结果表明，IDH 突变状态在血栓预防方面具有潜在的应用价值，需要进一步研究以阐明其相关性的机制。
