Application of four items of thrombosis detection in venous thrombosis of malignant tumor patients

Abstract

Objective To evaluate the clinical value of four items of thrombosis detection, including thrombin-antithrombin complex (TAT), α2-plasmin inhibitor-plasmin complex (PIC), thrombomodulin (TM) and tissue plasminogen activator-inhibitor complex (t-PAIC), combined with D-dimer (D-D) and fibrin degradation products (FDP) in venous thrombosis in patients with malignant tumor. Methods A total of 904 patients with malignant tumor from October 2017 to March 2019 in General Hospital of Heilongjiang Province Land Reclamation Bureau were selected (malignant tumor group), and 200 healthy physical examination patients were selected as healthy control group. Among 904 patients with malignant tumor, 92 patients had venous thrombosis (thrombosis group), and 812 patients had not venous thrombosis (non-thrombosis group). The TAT, PIC, TM, t-PAIC, FDP and D-D were detected. The relationship between TAT, PIC, TM, t-PAIC, D-D, FDP and venous thrombosis was analyzed by binary Logistic regression. The receiver operating characteristic (ROC) curve was used to determine the diagnostic performance of each index, and the maximum value of the Youden index was the optimal cut-off value. Results The TAT, PIC, TM, t-PAIC, D-D and FDP in malignant tumor group were significantly higher than those in healthy control group, and there were statistical differences (P 24.450 μg/L or PIC>2.624 mg/L were selected. Fourty-five cases of them were injected with low molecular weight heparin (experimental group) for 6 weeks, and another 45 cases were not treated with low molecular weight heparin (control group). Both groups were followed up for 1 year. The incidence of venous thrombosis in the experimental group was significantly lower than that in control group: 2.22% (1/45) vs. 15.56% (7/45), the survival time was significantly longer than that in control group: (10.6 ± 3.1) months vs. (8.5 ± 2.8) months, and there were statistical differences (P<0.05), and no bleeding occurred in experimental group. Conclusions Four items of thrombosis detection combined with D-D and FDP is better than single detection. It is the best non-invasive method to detect venous thrombosis. It can predict the possibility of venous thrombosis in patients with malignant tumor at an early stage, and help patients actively use preventing drug, determine the best and most reasonable treatment time, improve the prognosis of patients, and prolong survival time. Key words: Neoplasms; Venous thrombosis; Forecasting; Thrombomodulin; Thrombin-antithrombin complex; α2-plasmin inhibitor-plasmin complex; Tissue plasminogen activator-inhibitor complex