Ren Wenqin, Chen Hao, Huang Yujie, Zuo Jiaqian, Shu Xinyan, Shu Peng
Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu, China.
Department of Clinical Laboratory, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu, China.
Discov Oncol. 2024 Dec 4;15(1):748. doi: 10.1007/s12672-024-01311-7.
To comprehend the effects of diverse therapeutic interventions on thromboelastography (TEG) and conventional coagulation parameters among individuals diagnosed with colorectal cancer, this study aims to explore the clinical relevance of both thromboelastography and conventional coagulation metrics in evaluating coagulation function and predicting the incidence of thrombotic and hemorrhagic events in patients with colorectal cancer.
A cohort of 122 patients with colorectal cancer retrospectively recruited and divided into 2 groups: those undergoing surgical intervention (operation group) and those not subjected to surgery (non-operation group). According to the different types of treatment they received, the operation group was divided into chemotherapy-only group and a group receiving a combination of targeted therapy and chemotherapy. Blood samples were collected on admission and subjected to coagulation parameter assessment, including conventional coagulation tests and thromboelastography (TEG) assessment. Receiver operating characteristic (ROC) analysis was performed to predict the occurrence of complications in patients with colorectal cancer.
Compared with the operation group, the non-operation group showed significant reductions in reaction time(R-time) and kinetics time (K-time), and significant elevation in angle, maximum amplitude (MA), fibrinogen and platelets. Patients receiving targeted therapy and chemotherapy had lower angle and maximum amplitude and higher R-time and K-time, activated partial thromboplastin time and fibrinogen. The area under the curve for TEG in patients without treatment was 0.802. The area under the curve for TEG and conventional coagulation parameters were 0.654 and 0.660 respectively.
Diverse treatments distinctly impact on the coagulation indicators of individuals diagnosed with colorectal cancer. The coagulation parameters observed in patients prior to operation suggest a hypercoagulable state. Nevertheless, following postoperative chemotherapy and targeted therapy, this hypercoagulable state demonstrates a notable improvement, occasionally leading to a propensity for hypocoagulation. The findings of this investigation underscore the unique clinical importance of thromboelastography (TEG) alongside traditional coagulation parameters, demonstrating that these diagnostic tools possess complementary value and cannot be substituted interchangeably.
为了解不同治疗干预措施对结直肠癌患者血栓弹力图（TEG）及传统凝血参数的影响，本研究旨在探讨血栓弹力图和传统凝血指标在评估结直肠癌患者凝血功能及预测血栓形成和出血事件发生率方面的临床相关性。
回顾性招募122例结直肠癌患者，分为2组：接受手术干预的患者（手术组）和未接受手术的患者（非手术组）。手术组根据接受的不同治疗类型，分为单纯化疗组和接受靶向治疗联合化疗的组。入院时采集血样，进行凝血参数评估，包括传统凝血试验和血栓弹力图（TEG）评估。采用受试者工作特征（ROC）分析来预测结直肠癌患者并发症的发生情况。
与手术组相比，非手术组的反应时间（R-time）和动力学时间（K-time）显著缩短，角度、最大振幅（MA）、纤维蛋白原和血小板显著升高。接受靶向治疗联合化疗的患者角度和最大振幅较低，R-time、K-time、活化部分凝血活酶时间和纤维蛋白原较高。未接受治疗患者的TEG曲线下面积为0.802。TEG和传统凝血参数的曲线下面积分别为0.654和0.660。
不同治疗对结直肠癌患者的凝血指标有明显影响。术前患者的凝血参数提示处于高凝状态。然而，术后化疗和靶向治疗后，这种高凝状态有明显改善，偶尔会导致低凝倾向。本研究结果强调了血栓弹力图（TEG）与传统凝血参数独特的临床重要性，表明这些诊断工具具有互补价值，不能相互替代。
