European Journal of Cardiovascular Medicine

Cancer is one of the most vital reasons for the death globally where its treatment is the major cause of concern in affected subjects. Various factors have been assessed for the pathogenesis of the cancer and antigens for ABO blood group as expressed on the red blood cells are one of these factors.¹

There have been various studies that confirmed and reported a link between the risk of developing nasopharyngeal, breast, ovarian, pancreatic, and gastric cancer to the distribution of ABO blood group antigens.²

Few studies have been done that reported a correlation in intracranial neoplasm and ABO blood group antigen, however, the results reported have been controversial. Few studies in the literature have reported a high case of glioblastoma in subjects with A blood group, whereas, other studies have reported no significant association in in ABO blood group and CNS (central nervous system) neoplasms.³

Medulloblastoma is the most common malignant central nervous system embryonal neoplasm in child subjects. Existing literature data is scarce concerning the determination of relation between ABO blood group and medulloblastoma in child subjects.⁴ Hence, the present study was aimed to investigate the potential correlation between ABO-Rh blood types and the occurrence of Medulloblastoma inn Indian subjects and to evaluate the efficacy and use of blood group as a non-modifiable risk factor for medulloblastoma.

The present cross-control clinical study was aimed to investigate the potential correlation between ABO-Rh blood types and the occurrence of Medulloblastoma inn Indian subjects and to evaluate the efficacy and use of blood group as a non-modifiable risk factor for medulloblastoma. The study subjects were from Department of Pathology, Shree Narayan Medical Institute and Hospital, Saharsa, Bihar. Verbal and written informed consent were taken from all the subjects before study participation.

The study assessed 174 subjects aged less than/equal to 18 years with confirmed diagnosis of medulloblastoma as seen in histopathological assessment at the Institute within the defined study period. Diagnostic criteria used were histopathological assessment following biopsy or surgery from the tissue of the tumor. Rh factor, blood groups, ABO, gender, and age was assessed from all the included subjects from the previous records of the Institute. Another age and gender matched 200 subjects were included as controls that had no tumor. In both the groups, data were gathered concerning gender, age, Rh factor, and ABO blood group from the records of the Institute.

The data gathered underwent statistical analysis using IBM SPSS statistics version 24.0 using chi-square, student t-test, and one-way ANOVA. The data were expressed in number and percentage and mean and standard deviations. The p-value of <0.05 was taken as statistical significance value

The present cross-control clinical study was aimed to investigate the potential correlation between ABO-Rh blood types and the occurrence of Medulloblastoma inn Indian subjects and to evaluate the efficacy and use of blood group as a non-modifiable risk factor for medulloblastoma. The study assessed 174 subjects aged less than 18 years that were diagnosed with medulloblastoma on histopathological assessment at the Institute within the defined study period. Another age and gender matched 200 subjects were included as controls that had no tumor. In both the groups, data were gathered concerning gender, age, Rh factor, and ABO blood group from the records of the Institute. Comparison was done in controls and cases using statistical analysis.  

The study results showed that for demographic data and its correlation with blood group in two groups of study subjects, Rh factor was negative in 3% (n=6) controls and in 3.4% (n=6) cases and was positive in 97% (n=194) controls and 96.6% (n=168) cases. The difference was statistically non-significant with p=0.84. Blood group A, AB, B, and O was seen in 22% (n=44), 8% (n=16), 36% (n=72), and 34% (n=68) subjects from controls and in 41.4% (n=72), 10.3% (n=18), 26.4% (n=46), and 21.8% (n=38) cases. The difference was highly statistically significant with p=0.02. Mean age and gender distribution in two groups was comparable with p=0.324 and 0.97 respectively (Table 1).  

Table 1: Demographic data and its correlation with blood group in two groups of study subjects

On assessing the subtypes of medulloblastoma, their characteristics and corelation to ABO blood group, among 38 subjects with O blood groups, classical, desmoplastic, and large cell type was seen in 19.2% (n=28), 38.5% (n=10), and 0 subjects respectively. In 26.4% (n=46) with B blood group, 26% (n=38), 30.8% (n=8), and 0 subjects had classical, desmoplastic, and large cell type. Subjects with AB blood group, classical, desmoplastic, and large cell type was seen in 11% (n=16), 7.7% (n=2), and 0 study subjects respectively. In subjects with A blood group, classical, desmoplastic, and large cell type was seen in 43.8% (n=64), 23.1% (n=6), and 100% (n=2) study subjects. The difference was statistically non-significant with p=0.565 (Table 2).

Table 2: Medulloblastoma subtypes, their characteristics and corelation to ABO blood group

It was seen that for prevalence of type of medulloblastoma and its correlation to Rh factor, in 168 Rh-factor positive study subjects, classical, desmoplastic, and large cell type was seen in 95.9% (n=140), 100% (n=26), and 100% (n=2) study subjects respectively. In Rh-factor negative, 6 study subjects, classical type of medulloblastoma was seen in all 6 study subjects. There was total 146, 26, and 2 subjects with classical, desmoplastic, and large cell type medulloblastoma respectively (Table 3).

Table 3: Prevalence of type of medulloblastoma and its correlation to Rh factor

The study assessed 174 subjects aged less than 18 years that were diagnosed with medulloblastoma on histopathological assessment at the Institute within the defined study period. Another age and gender matched 200 subjects were included as controls that had no tumor. In both the groups, data were gathered concerning gender, age, Rh factor, and ABO blood group from the records of the Institute. Comparison was done in controls and cases using statistical analysis. The design of the present study was similar to the design by the previous studies of Kumarguru BN et al⁵ in 2017 and Allouh MZ et al⁶ in 2017 where study design comparable to the present study were also adopted by the authors in their respective studies.

It was seen that for demographic data and its correlation with blood group in two groups of study subjects, Rh factor was negative in 3% (n=6) controls and in 3.4% (n=6) cases and was positive in 97% (n=194) controls and 96.6% (n=168) cases. The difference was statistically non-significant with p=0.84. Blood group A, AB, B, and O was seen in 22% (n=44), 8% (n=16), 36% (n=72), and 34% (n=68) subjects from controls and in 41.4% (n=72), 10.3% (n=18), 26.4% (n=46), and 21.8% (n=38) cases. The difference was highly statistically significant with p=0.02. Mean age and gender distribution in two groups was comparable with p=0.324 and 0.97 respectively. These results were consistent with the findings of Mazumdar et al⁷ in 2011 and Agrawal A et al⁸ in 2014 where authors assessed subjects with demographic data and its correlation with blood group in their studies similar to the present study.

The study results showed that on assessing the subtypes of medulloblastoma, their characteristics and corelation to ABO blood group, among 38 subjects with O blood groups, classical, desmoplastic, and large cell type was seen in 19.2% (n=28), 38.5% (n=10), and 0 subjects respectively. In 26.4% (n=46) with B blood group, 26% (n=38), 30.8% (n=8), and 0 subjects had classical, desmoplastic, and large cell type. Subjects with AB blood group, classical, desmoplastic, and large cell type was seen in 11% (n=16), 7.7% (n=2), and 0 study subjects respectively. In subjects with A blood group, classical, desmoplastic, and large cell type was seen in 43.8% (n=64), 23.1% (n=6), and 100% (n=2) study subjects. The difference was statistically non-significant with p=0.565. These findings were in agreement with the results of Hsiao LT et al⁹ in 2015 and Franchini M et al¹⁰ in 2013 where subtypes of medulloblastoma, their characteristics and corelation to ABO blood group comparable to the present study was also reported by the authors in their studies.

On assessing the prevalence of type of medulloblastoma and its correlation to Rh factor, in 168 Rh-factor positive study subjects, classical, desmoplastic, and large cell type was seen in 95.9% (n=140), 100% (n=26), and 100% (n=2) study subjects respectively. In Rh-factor negative, 6 study subjects, classical type of medulloblastoma was seen in all 6 study subjects. There was total 146, 26, and 2 subjects with classical, desmoplastic, and large cell type medulloblastoma respectively. These results were in line with the findings of Franchini M et al¹¹ in 2014 and Jenkins PV et al¹² in 2006 where prevalence of type of medulloblastoma and its correlation to Rh factor reported by the authors was comparable to the present study.

The present study, considering its limitations, concludes that a higher risk for development of medulloblastoma is seen in study subjects with blood group A, whereas, least risk was seen in subjects with blood group O. These results suggest that blood group antigen should be taken as a preclinical and non-modifiable risk factor for development of medulloblastoma.

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