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

• Published in: Thrombosis research Vol. 223; pp. 36 - 43
• Main Authors: Ando, Kazuhiro, Natsumeda, Manabu, Kawamura, Masahide, Shirakawa, Kamon, Okada, Masayasu, Tsukamoto, Yoshihiro, Eda, Takeyoshi, Watanabe, Jun, Saito, Shoji, Takahashi, Haruhiko, Kakita, Akiyoshi, Oishi, Makoto, Fujii, Yukihiko
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.03.2023
• Subjects: Brain Neoplasms; CLEC-2; D-dimer; Glioma; Humans; Isocitrate dehydrogenase; Isocitrate Dehydrogenase - genetics; Malignant glioma; Mutation; Platelet Count; Podoplanin; Venous Thromboembolism; CLEC-2; D-dimer; Malignant glioma; Isocitrate dehydrogenase; Venous thromboembolism; Podoplanin
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/j.thromres.2023.01.018

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. 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. IDH-wildtype glioma patients highly expressed PDPN (P < 0.001) compared to IDH-mutant glioma patients. 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 %. 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. [Display omitted] •Soluble C-type lectin-like receptor (sCLEC-2) levels were correlate with podoplanin (PDPN) expression in patients with high grade gliomas.•IDH-wildtype glioma patients highly expressed PDPN compared to IDH-mutant glioma patients.•Platelet activation is strongly involved in the development of venous thromboembolism (VTE) in patients with IDH-wildtype high grade gliomas.