Abstract
Close correlation between oncologic diseases and blood coagulation disturbances dictates a necessity of prognosis of the main disease course and contemporary prevention of the thrombotic complications revealed. For this purpose, the global test for the hemostasis system assessment was used to reveal bleeding and thrombogenesis risks - "Thrombodynamics" (TD) allowing analysis in the real time of the thrombogenesis parameters in conditions the most resembling the natural functioning of the blood coagulation system. Parameters of TD test which enable differentiation between hyper-, normo- and hypocoagulation include the speed of the blood clot growth (the time of growth delay, initial and stationary blood clot growth) as well as the physical features of the clot (size and density). The aim of the present study was to access the capability of global hemostasis test Thrombodynamics in the evaluation of risk thrombotic complications in patients with cancer. Prospective investigation of hemostasis parameters was carried out in 23 patients with malignant tumors of the oral cavity, 25 patients with oropharynx cancer of I-II and III-IV stage, 23 patients - with brain metastasis, 21 patients - with glioblastoma aged 42-75 years (mean age 63.8±7.0). Standard coagulation test (activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin (by Quick), international normalized ratio (INR), and fibrinogen concentration are used to estimate hemostasis. The spatial growth of the fibrin clot was estimated in all patients using "Thrombodynamics T-2 Registrator." It was established that TD allowed registration of all types of plasma hypercoagulation manifestations: acceleration of the main clot growth, formation of the spontaneous clots and their different combinations. Sensitivity of international normalized ratio (INR) and thrombodynamics test, while revealing patient group with higher fibrin level, was 43% and 86%, accordingly. Reliable dynamic changes were found for all parameters of TD test during patients follow-up (p<0.05). The results of regression analysis showed that the time of clot growth delay, initial and stationary clot growth speed, and clot size were reliable thrombosis predictors. The study showed that TD test might be effective in revealing oncologic patients with high risk of thrombotic complications and for monitoring of efficiency/safety of the anticoagulant therapy.
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