Estimation of venous throm boembolism risk with thrombotic biomarkers in cancer patients
10.3760/cma.j.issn.0253-3766.2015.04.009
- VernacularTitle:血栓标志物评估恶性肿瘤患者静脉血栓风险
- Author:
Jianlong MEN
1
;
Diansheng ZHONG
;
Jing REN
Author Information
1. 天津医科大学总医院检验中心
- Keywords:
Biological markers;
Thromboembolism;
Neoplasms;
Venous thromboembolism;
D-dimer
- From:
Chinese Journal of Oncology
2015;(4):283-289
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the value of thrombotic biomarkers in estimation of venous thromboembolism ( VTE) risk in cancer patients.Methods A total of 1473 cancer patients treated in the Tianjin Medical University General Hospital from 2009 to 201 were selected, including 845 males and 628 females in the age of 56±17 years.The activities of von Willebrand factor antigen ( vWF:Ag) , factorⅦ( FⅦ:A), factor Ⅷ (FⅧ:A), antithrombin (AT:A), protein C (PC:A) and protein S (PS:A) were assayed using an ACL TOP 700 blood coagulation analyzer.The level of D-dimer ( D-D) was assayed using the Biomerieux Mini Vidas Automated Immunoassay Analyzer.Receiver operating characteristic curve ( ROC) was used to analyze the diagnostic performance of the parameters.Cox regression analysis model was applied to evaluate the effect on prognosis, and Kaplan-Meier curve was used to implement the survival analysis.Results The levels of vWF:Ag, D-D, and FⅧ:A were significantly higher in all the specified tumor groups ( except the other tumor group ) than that of the control groups ( P<0.05 ) .FⅧ:A was significantly higher than that in the control group in all tumor groups except the renal carcinoma, prostatic cancer, lymphoma groups and the other tumor group ( P<0.05) .The PC:A level was significantly lower in all tumor patients groups than in the control group, except glioma, breast cancer, gastric carcinoma, renal carcinoma and the other tumors groups ( P<0.05) .The PS:A level was significantly lower in all tumor groups than in the control group, except the glioma, breast cancer, prostatic cancer, lymphoma and the other tumors groups (P<0.05).The AT:A level was significantly lower in all tumor groups than in the control group (P<0.05).When the optimum cut-off point of vWF:Ag for VTE diagnosis was 192%in the cancer group, the area under ROC curve=0.828 ( 95%CI:0.716 to 0.939) .When the optimum cut-off point of D-dimer for VTE diagnosis was 1484 ng/ml in the cancer group, the area under ROC curve=0.915 ( 95%confidence interval: 0.840 to 0.988).When the optimum cut-off point of PC:A for VTE diagnosis was 75.2%in the cancer group, the area under ROC curve=0.764 ( 95%confidence interval:0.630 to 0.898) . The Cox analysis showed that age, surgery, chemotherapy and D-dimer were independent risk factors for VTE event within three months in cancer patients.The cumulative probability of VTE was increased significantly in the cancer patients if whose plasma D-dimer level was over the cut-off value.Conclusions The plasma D-dimer level is obviously increased in cancer patients, and there is a relevance to thrombosis risk stratification and VTE cumulative probability.It is with good diagnostic performance, and may be used as an effective marker in estimation of VTE risk within 3 months in cancer patients.
