Abstract
Introduction: Pancreatic cancer has the highest risk for venous thrombosis of all gastrointestinal malignancies. Although there are recent consensus guidelines for anticoagulation in cancer patients, the implimentation of prophlaxis anticoagulation is still sub optimal. Current diagnostic tests are unreliable in predicting cancer related hypercoagulability, leading to interest in examining the kinetics of clot formation by thrombelastography. We hypothesize that thrombelastography will characterize hypercoagulability in a metastatic murine model of pancreatic adenocarcinoma. Methods: C57/BL6 mice, age 7-9 weeks, underwent splenic inoculation with 2.5×105 Pan02 murine pancreatic adenocarcinoma cells. At necropsy, (7 weeks) blood was collected with citrate (1:10 ratio) and TEG was obtained on Thrombelastograph® Analyzer. TEG was compared between mice with cancer and control mice. Data were analyzed using non-parametric methods because our n=5. Results: Mice with cancer were found to have significantly higher Maximum Amplitude (MA) and G than control mice. Median MA was 60.6 (IQR: 59.4-62) mm in control mice compared to 74.2 (IQR 71.2-76) mm in mice with cancer. Conclusions: Thrombelastography identifies hypercoagulability in an immunocompetent murine metastatic pancreatic cancer model. Further, as thromboelastography can identify abnormalities in blood coagulation, specific patient guided anti-coagulation treatment may be possible.
Highlights
Pancreatic cancer has the highest risk for venous thrombosis of all gastrointestinal malignancies
Pancreatic cancer has the highest risk for venous thrombosis, with reported incidences ranging from 17% to 57% [1]
Venous thrombotic Events (VTE) and malignancies have been linked since Trousseau described the association in pancreas cancer patients in the 1870s [2]
Summary
Pancreatic cancer has the highest risk for venous thrombosis of all gastrointestinal malignancies. Pancreatic cancer is the 4th leading cause of cancer death. Pancreatic cancer has the highest risk for venous thrombosis, with reported incidences ranging from 17% to 57% [1]. Venous thrombotic Events (VTE) are associated with poor outcomes in all cancer patients. VTE and malignancies have been linked since Trousseau described the association in pancreas cancer patients in the 1870s [2]. VTEs are the leading cause of death at 30 days after cancer surgery, but they predict decreased survival during the first year for all types of cancer [3,4,5,6], VTE prevention is of great interest
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