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

doi:10.3877/cma.j.issn.2095-9141.2022.03.006

Abstract

Abstract:

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.

Key words: ATRX, Glioma, Prognosis, Isocitrate dehydrogenase, Meta-analysis

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.

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References 29

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作者	出版时间	国家	样本量	胶质瘤种类	分级（Ⅰ~Ⅱ/Ⅲ~Ⅳ）	IDH突变/野生	ATRX缺失/表达	观察指标	HR(95%CI)	NOS评分
Cai等^[3]	2018	中国	421	多种类	77/344	-	-	-	-	7
Jiao等^[4]	2012	美国	363	多种类	70/293	-	-	-	-	8
Leeper等^[8]	2015	美国	159	多种类	-	70/14	64/20	OS	0.41(0.17~0.99)	8
Leeper等^[8]	2015	美国	159	多种类	-	70/14	64/20	PFS	0.35(0.21~0.58)	8
Wiestler等^[11]	2013	德国	133	多种类	-	98/32	44/86	TTF	0.26(0.12~0.56)	7
Mur等^[12]	2015	西班牙	272	多种类	96/176	112/147	48/211	OS	0.33(0.18~0.61)	8
Chaurasia等^[13]	2016	韩国	163	GBM	-	17/146	25/138	OS	0.66(0.45~0.97)
Chaurasia等^[13]	2016	韩国	163	GBM	-	17/146	25/138	PFS	0.63(0.44~0.92)	7
Pekmezci等^[14]	2017	美国	360	GBM	-	51/309	46/314	OS	0.29(0.14~0.60)	8
Ebrahimi等^[15]	2016	德国	1039	多种类	321/543	321/543	207/657	OS	0.55(0.43~0.70)	8
Chatterjee等^[16]	2018	印度	100	多种类	40/60	34/66	35/62	-	-	6
Cai等^[17]	2016	中国	402	多种类	125/277	-	-	PFS	0.64(0.48~0.85)	7
Cai等^[18]	2016	中国	117	多种类	-	43/74	55/62	PFS	0.58(0.40~0.85)	7
王轶群等^[19]	2017	中国	97	多种类	-	-	45/52	OS	0.45(0.26~0.78)	7
张东旭等^[20]	2019	中国	72	多种类	-	-	56/16	PFS	-	6
朱文标等^[21]	2020	中国	104	多种类	27/77	-	-	PFS	-	6
Hempel等^[22]	2018	德国	450	多种类	78/372	-	85/365	OS	0.68(0.49~0.94)	8
Hempel等^[23]	2019	德国	77	多种类	33/44	-	30/57	OS	0.96(0.34~2.71)	6
Hempel等^[23]	2019	德国	77	多种类	33/44	-	30/57	PFS	0.46(0.22~0.96)	6
Liu等^[24]	2012	加拿大	127	多种类	31/96	-	31/96	-	-	6
Takano等^[25]	2016	日本	137	多种类	35/102	-	69/68	-	-	7

作者	出版时间	国家	样本量	胶质瘤种类	分级（Ⅰ~Ⅱ/Ⅲ~Ⅳ）	IDH突变/野生	ATRX缺失/表达	观察指标	HR(95%CI)	NOS评分
Cai等^[3]	2018	中国	421	多种类	77/344	-	-	-	-	7
Jiao等^[4]	2012	美国	363	多种类	70/293	-	-	-	-	8
Leeper等^[8]	2015	美国	159	多种类	-	70/14	64/20	OS	0.41(0.17~0.99)	8
Leeper等^[8]	2015	美国	159	多种类	-	70/14	64/20	PFS	0.35(0.21~0.58)	8
Wiestler等^[11]	2013	德国	133	多种类	-	98/32	44/86	TTF	0.26(0.12~0.56)	7
Mur等^[12]	2015	西班牙	272	多种类	96/176	112/147	48/211	OS	0.33(0.18~0.61)	8
Chaurasia等^[13]	2016	韩国	163	GBM	-	17/146	25/138	OS	0.66(0.45~0.97)
Chaurasia等^[13]	2016	韩国	163	GBM	-	17/146	25/138	PFS	0.63(0.44~0.92)	7
Pekmezci等^[14]	2017	美国	360	GBM	-	51/309	46/314	OS	0.29(0.14~0.60)	8
Ebrahimi等^[15]	2016	德国	1039	多种类	321/543	321/543	207/657	OS	0.55(0.43~0.70)	8
Chatterjee等^[16]	2018	印度	100	多种类	40/60	34/66	35/62	-	-	6
Cai等^[17]	2016	中国	402	多种类	125/277	-	-	PFS	0.64(0.48~0.85)	7
Cai等^[18]	2016	中国	117	多种类	-	43/74	55/62	PFS	0.58(0.40~0.85)	7
王轶群等^[19]	2017	中国	97	多种类	-	-	45/52	OS	0.45(0.26~0.78)	7
张东旭等^[20]	2019	中国	72	多种类	-	-	56/16	PFS	-	6
朱文标等^[21]	2020	中国	104	多种类	27/77	-	-	PFS	-	6
Hempel等^[22]	2018	德国	450	多种类	78/372	-	85/365	OS	0.68(0.49~0.94)	8
Hempel等^[23]	2019	德国	77	多种类	33/44	-	30/57	OS	0.96(0.34~2.71)	6
Hempel等^[23]	2019	德国	77	多种类	33/44	-	30/57	PFS	0.46(0.22~0.96)	6
Liu等^[24]	2012	加拿大	127	多种类	31/96	-	31/96	-	-	6
Takano等^[25]	2016	日本	137	多种类	35/102	-	69/68	-	-	7

Logor	Exp(b)	Std.Err.	t	P>｜t｜	95%CI
地区	1.243	0.522	0.52	0.621	0.460~3.356
样本量	0.512	0.231	-1.48	0.181	0.177~1.486
胶质瘤种类	2.527	1.918	1.22	0.261	0.420~15.205
截距_cons	1.973	0.716	1.87	0.103	0.836~4.654

Logor	Exp(b)	Std.Err.	t	P>｜t｜	95%CI
地区	1.243	0.522	0.52	0.621	0.460~3.356
样本量	0.512	0.231	-1.48	0.181	0.177~1.486
胶质瘤种类	2.527	1.918	1.22	0.261	0.420~15.205
截距_cons	1.973	0.716	1.87	0.103	0.836~4.654

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