TY - JOUR

T1 - Thrombotic risk assessment in brain gliomas and meningiomas

T2 - Оценка тромботического риска при глиальных и менинготелиальных опухолях головного мозга

AU - Sturov, Viktor G.

AU - Prokhorov, Oleg B.

AU - Moisak, Galina I.

AU - Rzaev, Jamil A.

AU - Kudlay, Dmitry A.

PY - 2024/12/10

Y1 - 2024/12/10

N2 - Introduction. Brain tumors are one of the predominant risk factors for the development of venous thromboembolic complications (VTEС). In particular, in gliomas, hemostasis disorders are attributable to the leading role of tissue factor and the depression of cellular activation of the fibrinolysis system. At the same time, there was virtually no assessment of the coagulation status in meningiomas. Аim: to evaluate coagulation in patients with brain gliomas and meningiomas for the prediction of microthrombotic risk. Materials and Methods. A prospective, uncontrolled, observational, non-randomized study was conducted. Hemostasis parameters were evaluated in 43 patients with brain gliomas and 54 patients with brain meningiomas. The basic information about patients, the characteristics of tumors according to magnetic resonance imaging (MRI) findings, concomitant diseases, tumors histology, and the results of laboratory blood tests before surgery were retrospectively analyzed. The presence of thrombosis was confirmed by veins duplex scanning of the lower extremities before and after surgical treatment. Results. VTEС incidence among patients with brain tumors was 23.7%, with 25.6% among those with gliomas and 22.2% among those with meningiomas. Significant thrombotic risk factors in patients with gliomas were decreased values of international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (p < 0.01), platelet count (p < 0.05) and increased prothrombin according to Quick, D-dimer level (p < 0.01) and leukocyte count (p < 0.05), increased age (p < 0.001), concomitant arterial hypertension and IDH-wildtype phenotype with increased levels of isocitrate dehydrogenase enzyme in serum (p < 0.05). In patients with meningiomas, an increase in D-dimer level (p < 0.01), older age, and the presence of concomitant obesity (p < 0.05) were identified. Spearman correlation analysis in the group with gliomas showed that an increase in D-dimer level correlated with an increase in the expression of the tumor cell nuclear proliferative activity marker Ki-67 (R = 0.532; p < 0.01) and the degree of histological tumor malignancy (Grade) according to the generally accepted scale in oncology — ​Grading of Recommendations Assessment, Development and Evaluation (R = 0.406; p < 0.05), while the increase in leukocytes count positively correlates with neoplasm volume (R = 0.561; p < 0.001), Grade (R = 0.428; p = 0.01) and Ki-67 (R = 0.397; p < 0.05). Conclusion. An increased VTEC risk is associated with hypercoagulability in patients with brain gliomas and meningi-omas. Increased D-dimer level and leukocyte count correlate with glioma progression.

AB - Introduction. Brain tumors are one of the predominant risk factors for the development of venous thromboembolic complications (VTEС). In particular, in gliomas, hemostasis disorders are attributable to the leading role of tissue factor and the depression of cellular activation of the fibrinolysis system. At the same time, there was virtually no assessment of the coagulation status in meningiomas. Аim: to evaluate coagulation in patients with brain gliomas and meningiomas for the prediction of microthrombotic risk. Materials and Methods. A prospective, uncontrolled, observational, non-randomized study was conducted. Hemostasis parameters were evaluated in 43 patients with brain gliomas and 54 patients with brain meningiomas. The basic information about patients, the characteristics of tumors according to magnetic resonance imaging (MRI) findings, concomitant diseases, tumors histology, and the results of laboratory blood tests before surgery were retrospectively analyzed. The presence of thrombosis was confirmed by veins duplex scanning of the lower extremities before and after surgical treatment. Results. VTEС incidence among patients with brain tumors was 23.7%, with 25.6% among those with gliomas and 22.2% among those with meningiomas. Significant thrombotic risk factors in patients with gliomas were decreased values of international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (p < 0.01), platelet count (p < 0.05) and increased prothrombin according to Quick, D-dimer level (p < 0.01) and leukocyte count (p < 0.05), increased age (p < 0.001), concomitant arterial hypertension and IDH-wildtype phenotype with increased levels of isocitrate dehydrogenase enzyme in serum (p < 0.05). In patients with meningiomas, an increase in D-dimer level (p < 0.01), older age, and the presence of concomitant obesity (p < 0.05) were identified. Spearman correlation analysis in the group with gliomas showed that an increase in D-dimer level correlated with an increase in the expression of the tumor cell nuclear proliferative activity marker Ki-67 (R = 0.532; p < 0.01) and the degree of histological tumor malignancy (Grade) according to the generally accepted scale in oncology — ​Grading of Recommendations Assessment, Development and Evaluation (R = 0.406; p < 0.05), while the increase in leukocytes count positively correlates with neoplasm volume (R = 0.561; p < 0.001), Grade (R = 0.428; p = 0.01) and Ki-67 (R = 0.397; p < 0.05). Conclusion. An increased VTEC risk is associated with hypercoagulability in patients with brain gliomas and meningi-omas. Increased D-dimer level and leukocyte count correlate with glioma progression.

KW - D-dimer

KW - VTEС

KW - brain tumor

KW - gliomas

KW - hypercoagulation

KW - meningiomas

KW - venous thromboembolic complications

UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-85212519033&origin=inward&txGid=4c730ac704d59ca06965cf350e564499

UR - https://www.mendeley.com/catalogue/84fc98d1-c808-3354-b08c-1105c2abe3f2/

U2 - 10.25555/THR.2024.4.1124

DO - 10.25555/THR.2024.4.1124

M3 - Article

VL - 2024

SP - 68

EP - 79

JO - Тромбоз, гемостаз и реология

JF - Тромбоз, гемостаз и реология

SN - 2078-1008

IS - 4

ER -