Ma Jun, Tang Yujing, Zhou Jingyi, Zhao Aimin, Shi Jun
Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Clinical Laboratory, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Clin Appl Thromb Hemost. 2025 Jan-Dec;31:10760296251324918. doi: 10.1177/10760296251324918. Epub 2025 Apr 13.
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 ( = .025, = .030). D3 after operation, TAT, TM, PIC and t-PAIC levels in malignant tumor group were significantly higher than those in benign tumor group ( < .0001, = .036, = .037, < .0001). PIC level of the VTE group was significantly higher than that of the non-VTE group in malignant patients ( < .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.
妇科恶性肿瘤手术常常会增加静脉血栓栓塞症（VTE）的发生率。凝血酶 - 抗凝血酶复合物（TAT）、血栓调节蛋白（TM）、纤溶酶 - 抗纤溶酶复合物（PIC）、组织型纤溶酶原激活物 - 纤溶酶原激活抑制物复合物（t - PAIC）被认为对妇科恶性肿瘤患者凝血和纤溶平衡的变化具有潜在的监测意义。我们旨在探讨TAT、PIC、TM、t - PAIC作为妇科恶性肿瘤手术患者术后VTE的诊断和预测新标志物，并评估其相关高危因素。选取103例妇科手术患者。将恶性肿瘤患者分为VTE组和非VTE组。所有患者在术前及术后第1天、第3天采用化学发光免疫分析法检测TAT、TM、PIC和t - PAIC。术后1个月，恶性肿瘤组深静脉血栓形成（DVT）发生率为10.20%。术前，恶性肿瘤组PIC、t - PAIC水平显著高于良性肿瘤组（P = 0.025，P = 0.030）。术后第3天，恶性肿瘤组TAT、TM、PIC和t - PAIC水平显著高于良性肿瘤组（P < 0.0001，P = 0.036，P = 0.037，P < 0.0001）。恶性肿瘤患者中，VTE组的PIC水平显著高于非VTE组（P < 0.0001）。Logistic回归分析显示，术前PIC和术后PIC是VTE的独立因素。术前PIC和术后PIC的曲线下面积（AUC）分别为0.95、0.941，敏感度分别为100%、100%，特异度分别为86.4%、88.6%。作为妇科恶性手术后VTE的新预测生物标志物，术前PIC和术后PIC水平是DVT的独立危险因素，具有准确的诊断价值。
