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中华神经创伤外科电子杂志 ›› 2022, Vol. 08 ›› Issue (03) : 161 -167. doi: 10.3877/cma.j.issn.2095-9141.2022.03.006

临床研究

ATRX丢失与胶质瘤患者预后及IDH突变相关性的Meta分析
袁英淇1, 闫润芝2, 范益民3,()   
  1. 1. 030001 太原市人民医院神经外科
    2. 030001 太原,山西医科大学第一临床医学院
    3. 030001 太原,山西医科大学第一医院神经外科
  • 收稿日期:2021-10-26 出版日期:2022-06-15
  • 通信作者: 范益民
  • 基金资助:
    山西省应用基础研究计划面上青年基金项目(201901D211478)

Meta-analysis of correlation between ATRX loss and the prognosis and IDH mutation in glioma patients

Yingqi Yuan1, Runzhi Yan2, Yimin Fan3,()   

  1. 1. Department of Neurosurgery, Taiyuan People’s Hospital, Taiyuan 030001, China
    2. The First Clinical Medical College of Shanxi Medical University, Taiyuan 030001, China
    3. Department of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan 030001, China
  • Received:2021-10-26 Published:2022-06-15
  • Corresponding author: Yimin Fan
引用本文:

袁英淇, 闫润芝, 范益民. ATRX丢失与胶质瘤患者预后及IDH突变相关性的Meta分析[J]. 中华神经创伤外科电子杂志, 2022, 08(03): 161-167.

Yingqi Yuan, Runzhi Yan, Yimin Fan. Meta-analysis of correlation between ATRX loss and the prognosis and IDH mutation in glioma patients[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2022, 08(03): 161-167.

目的

分析α-地中海贫血/精神发育迟滞综合征X染色体相关基因(ATRX)表达丢失对脑胶质瘤患者预后的影响,同时探究其与胶质瘤分级、胶质瘤分子标志物异柠檬酸脱氢酶(IDH)突变之间的相关性。

方法

利用计算机检索PubMed、Medline、Web of Science、Ovid、万方医学网、中国知网等数据库,收集自建库至2020年6月国内外发表的关于ARTX表达状态与胶质瘤患者预后及相关指标关系的文献,应用Revman 5.3计算机软件进行Meta分析。

结果

共纳入文献18篇,4593例患者。其中8篇文献报道了ATRX表达情况与胶质瘤患者总生存期(OS)的关系,结果显示ATRX表达丢失,胶质瘤患者预后更好(HR=0.55,95%CI:0.47~0.64,P<0.001);纳入的5篇文献报道了ATRX的表达情况与胶质瘤患者无病生存期(PFS)的关系,结果显示ATRX丢失,胶质瘤患者PFS显著延长(HR=0.57,95%CI:0.48~0.68,P<0.001);纳入的11篇文献报道了ATRX表达情况与胶质瘤级别的关系,结果显示ATRX表达情况与胶质瘤发生级别显著相关,ATRX丢失更易发生于低级别胶质瘤(OR=2.11,95%CI:1.46~3.05,P<0.001);纳入的7篇文献报道了ATRX表达情况与IDH突变的关系,结果显示ATRX丢失利于IDH突变(OR=13.97,95%CI:10.23~19.08,P<0.001)。

结论

ATRX丢失提示胶质瘤患者预后更好,其与肿瘤分级、IDH突变具有密切的相关性。

Objective

To analyze the effect of the loss of expression of alpha-thulassemia/mental retardation syndrome X-linked gene (ATRX) on the prognosis of patients with gliomas, and to explore its correlation between glioma grade and glioma molecular marker isocitrate dehydrogenase (IDH) mutation.

Methods

The databases of PubMed, Medline, Web of Science, Ovid, Wanfang Medical Network, CNKI, etc. were retrieved by computer. The literatures on the relationship between the expression of ARTX and the prognosis and related indicators of glioma patients published at home and abroad from inception to June 2020 were collected. Meta-analysis was performed by Revman 5.3 computer software.

Results

A total of 18 literatures and 4593 patients were included. Among them, 8 articles reported the relationship between ATRX expression and the overall survival (OS) of glioma patients. The results showed that a loss of ATRX expression, and patients with glioma have a better prognosis (HR=0.55, 95%CI: 0.47-0.64, P<0.001); Five literature articles literatures reported the relationship between the expression of ATRX and disease-free survival (PFS) in patients with glioma. The results showed that ATRX was lost and the PFS of glioma patients was significantly prolonged (HR=0.57, 95%CI: 0.48-0.68, P<0.001); 11 included literatures reported the relationship between ATRX expression and glioma grade. The results showed that the expression of ATRX was significantly correlated with the grade of glioma, and the loss of ATRX was more likely to occur in low-grade gliomas (OR=2.11, 95%CI: 1.46-3.05, P<0.001); Seven included literature articles reported the relationship between ATRX expression and IDH mutation, with a total of 1987 patients. The results showed that ATRX loss was beneficial to IDH mutation (OR=13.97, 95%CI: 10.23-19.08, P<0.001).

Conclusion

The loss of ATRX indicates that patients with glioma have a better prognosis, which is closely related to tumor grade and IDH mutation.

图1 文献筛选流程图
图2 纳入文献纽卡斯尔-渥太华量表质量评价表
表1 纳入文献基本特征
图3 ATRX表达丢失与胶质瘤患者OS、PFS关系的Meta分析森林图A:ATRX表达丢失与胶质瘤患者OS的关系;B:ATRX表达丢失与胶质瘤患者PFS的关系;ATRX:α-地中海贫血/精神发育迟滞综合征X染色体相关基因;OS:总生存期;PFS:无病生存期
图4 敏感性分析
图5 ATRX表达丢失与胶质瘤分级、IDH突变关系的Meta分析森林图A:ATRX表达丢失与胶质瘤分级的关系;B:ATRX表达丢失与胶质瘤患者IDH突变的关系;ATRX:α地中海贫血/精神发育迟滞综合征X染色体相关基因;IDH:异柠檬酸脱氢酶
表2 Meta回归分析结果
图6 纳入文献的漏斗图A:ATRX与胶质瘤患者OS的关系;B:ATRX与胶质瘤分级的关系;ATRX:α-地中海贫血/精神发育迟滞综合征X染色体相关基因;OS:总生存期;HR:危险比
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