Plasmin-Antiplasmin Complex as a New Predictive Marker of Postoperative Venous Thromboembolism in Patients with Gynecologic Malignancy

纤溶酶-抗纤溶酶复合物作为妇科恶性肿瘤患者术后静脉血栓栓塞的新型预测标志物

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Abstract

Surgery of gynecologic malignancies often increases the incidence of Venous thromboembolism (VTE). TAT, TM, PIC, t-PAIC are considered to be potential monitoring significance for the change of coagulation and fibrinolytic balance with gynecological malignant tumors. We aimed to explore TAT, PIC, TM, t-PAIC as diagnostic and predictive new marker of postoperative VTE for patients undergoing surgery of gynecologic malignancies and evaluate its related high-risk factors. 103 cases of gynecological surgery were selected. The malignant tumor patients were divided into VTE and non-VTE group. All patients were detected by chemiluminescence immunoassay for TAT, TM, PIC and t-PAIC before and d1, d3 after operation. One month after surgery, the incidence rate of deep vein thrombosis(DVT) in malignant tumor group was 10.20%. Before operation, PIC, t-PAIC levels in malignant tumor group were significantly higher than those in benign tumor group (P = .025, P = .030). D3 after operation, TAT, TM, PIC and t-PAIC levels in malignant tumor group were significantly higher than those in benign tumor group (P < .0001, P = .036, P = .037, P < .0001). PIC level of the VTE group was significantly higher than that of the non-VTE group in malignant patients (P < .0001). Logistics regression analysis showed that pre-PIC and post-PIC were independent factors of VTE. The AUC of pre-PIC and post-PIC were 0.95, 0.941, with a sensitivity of 100%, 100% and a specificity of 86.4%, 88.6%. As a new predictive biomarker for VTE after the gynecologic malignant surgery, pre-PIC and post-PIC levels are the independent risk factors of DVT and has accurate diagnostic value.

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