Elevated ratio of C-type lectin-like receptor 2 level and platelet count (C2PAC) aids in the diagnosis of post-operative venous thromboembolism in IDH-wildtype gliomas
Elevated ratio of C-type lectin-like receptor 2 level and platelet count (C2PAC) aids in the diagnosis of post-operative venous thromboembolism in IDH-wildtype gliomas
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DOI：
10.1016/j.thromres.2023.01.018
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发表时间：
2023-01-25
影响因子：
3.9
通讯作者：
Fujii, Yukihiko
中科院分区：
文献类型：
--
作者：
Ando, Kazuhiro;Natsumeda, Manabu;Fujii, Yukihiko
介绍：Podoplanin（PDPN）通过与血小板表面的C型凝集素样受体2相互作用诱导血小板聚集，并参与术后静脉血栓栓塞（VTE）的形成。在这项研究中，我们研究了可溶性C型凝集素样受体（sCLEC-2）水平和PDPN表达在高级别胶质瘤患者之间的相关性，以及sCLEC-2水平和VTE发生之间的关系。材料与方法：纳入了2018年4月至2020年8月在新泻大学神经外科手术治疗的44例高级别胶质瘤患者。高级别胶质瘤患者分为异柠檬酸脱氢酶（IDH）-野生型和突变型组，并通过免疫组化证实VTE的存在或不存在以及PDPN的强度。测定这些患者的血小板计数以及血浆sCLEC-2和PDPN。此外，sCLEC-2浓度水平除以血小板计数（C2 PAC指数）进行比较。结果：IDH野生型胶质瘤患者PDPN表达高于IDH突变型胶质瘤患者（P < 0.001）。在随访期间，共有9例（20.5%）患者被诊断为VTE，其中8例患者患有IDH野生型胶质瘤，1例患者患有IDH突变型胶质瘤。IDH野生型胶质瘤患者的平均sCLEC-2水平和C2 PAC指数显著高于PDPN低表达或无表达组，包括IDH突变型胶质瘤患者（P = 0.0004，P = 0.0002）。在IDH野生型胶质瘤患者中，VTE患者的C2 PAC指数显著高于无VTE患者（P = 0.0492）。C2 PAC预测IDH-野生型胶质瘤患者VTE的最佳临界点为3.7，敏感性为87.5%，特异性为51.9%。结论：血小板活化与IDH-野生型高级别胶质瘤患者的VTE发展密切相关，C2 PAC指数是检测术后VTE形成的潜在标志物。
Introduction: Podoplanin (PDPN) is known to induce platelet aggregation via interacting with the C-type lectin-like receptor-2 on platelets and is involved in postoperative venous thromboembolism (VTE) formation. In this study, we investigate the correlation between soluble C-type lectin-like receptor (sCLEC-2) levels and PDPN expression in patients with high grade gliomas and the relationship between sCLEC-2 levels and the occurrence of VTE. Materials and methods: Forty-four patients harboring high grade gliomas, treated surgically at the Department of Neurosurgery, Niigata University from April 2018 to August 2020, were included. Patients with high grade gliomas were divided into isocitrate dehydrogenase (IDH)-wildtype and mutant groups, and the presence or absence of VTE and the intensity of PDPN by immunohistochemistry were confirmed. Platelet counts, as well as plasma sCLEC-2 and PDPN were measured in these patients. Furthermore, the levels of sCLEC-2 concentration were divided by the platelet count (C2PAC index) for comparison. Results: IDH-wildtype glioma patients highly expressed PDPN (P < 0.001) compared to IDH-mutant glioma pa-tients. In total, 9 (20.5 %) patients were diagnosed with VTE during the follow-up period, of which 8 patients harbored IDH-wildtype gliomas, and one patient an IDH-mutant glioma. Mean sCLEC-2 levels and C2PAC index in patients with IDH-wildtype gliomas were significantly higher than that of low or no PDPN expression group, which included patients with IDH-mutant gliomas (P = 0.0004, P = 0.0002). In patients with IDH-wildtype gliomas, the C2PAC index in patients with VTE was significantly higher than in patients without VTE (P = 0.0492). The optimal cutoff point of C2PAC for predicting VTE in IDH-wildtype glioma patients was 3.7 with a sensitivity of 87.5 % and specificity of 51.9 %. Conclusion: Platelet activation is strongly involved in the development of VTE in patients with IDH-wildtype high grade gliomas, and C2PAC index is a potential marker to detect VTE formation after surgery.