Department of Clinical Biochemistry, 11297Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, 1006Aarhus University, Aarhus, Denmark.
Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231152897. doi: 10.1177/10760296231152897.
Patients with lung cancer face a substantially increased risk of thromboembolic disease. Patients with localized non-small cell lung cancer (NSCLC) who are unfit for surgery due to age or comorbidity have additional thrombotic risk factors. Thus, we aimed to investigate markers of primary and secondary hemostasis, since this could assist in treatment decisions. We included 105 patients with localized NSCLC. Ex vivo thrombin generation was determined by calibrated automated thrombogram and in vivo thrombin generation was determined by measurement of thrombin-antithrombin complex (TAT) levels and prothrombin fragment F1 + 2 concentrations (F1 + 2). Platelet aggregation was investigated by impedance aggregometry. Healthy controls were used for comparison. TAT and F1 + 2 concentrations were significantly higher in NSCLC patients than in healthy controls ( < .001). The levels of ex vivo thrombin generation and platelet aggregation were not increased in the NSCLC patients. Patients with localized NSCLC considered unfit for surgery had significantly increased in vivo thrombin generation. This finding should be further investigated as it could be relevant for the choice of thromboprophylaxis in these patients.
肺癌患者面临着明显增加的血栓栓塞疾病风险。由于年龄或合并症而不适合手术的局限性非小细胞肺癌（NSCLC）患者有额外的血栓形成危险因素。因此，我们旨在研究原发性和继发性止血的标志物，因为这可能有助于治疗决策。我们纳入了 105 名局限性 NSCLC 患者。通过校准自动血栓图测定体外凝血酶生成，通过测定凝血酶-抗凝血酶复合物（TAT）水平和凝血酶原片段 F1+2 浓度（F1+2）测定体内凝血酶生成。通过阻抗聚集法研究血小板聚集。使用健康对照组进行比较。与健康对照组相比，NSCLC 患者的 TAT 和 F1+2 浓度明显升高（<0.001）。NSCLC 患者的体外凝血酶生成和血小板聚集水平没有增加。被认为不适合手术的局限性 NSCLC 患者体内凝血酶生成明显增加。这一发现值得进一步研究，因为它可能与这些患者的血栓预防选择有关。
