title: [Estimation of venous thromboembolism risk with thrombotic biomarkers in cancer patients].
abstract: OBJECTIVE
  To assess the value of thrombotic biomarkers in estimation of venous thromboembolism (VTE) risk in cancer patients.
  
  
  METHODS
  A total of 1473 cancer patients treated in the Tianjin Medical University General Hospital from 2009 to 201 were selected, including 845 males and 628 females in the age of 56 ± 17 years. The activities of von Willebrand factor antigen (vWF:Ag), factor VII (F VII:A), factor VIII (F VIII:A), antithrombin (AT:A), protein C (PC:A) and protein S (PS:A) were assayed using an ACL TOP 700 blood coagulation analyzer. The level of D-dimer (D-D) was assayed using the Biomerieux Mini Vidas Automated Immunoassay Analyzer. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic performance of the parameters. Cox regression analysis model was applied to evaluate the effect on prognosis, and Kaplan-Meier curve was used to implement the survival analysis.
  
  
  RESULTS
  The levels of vWF:Ag, D-D, and F VIII:A were significantly higher in all the specified tumor groups ( except the other tumor group ) than that of the control groups (P < 0.05). F VIII:A was significantly higher than that in the control group in all tumor groups except the renal carcinoma, prostatic cancer, lymphoma groups and the other tumor group (P < 0.05). The PC:A level was significantly lower in all tumor patients groups than in the control group, except glioma, breast cancer, gastric carcinoma, renal carcinoma and the other tumors groups (P < 0.05). The PS: A level was significantly lower in all tumor groups than in the control group, except the glioma, breast cancer, prostatic cancer, lymphoma and the other tumors groups (P<0.05). The AT: A level was significantly lower in all tumor groups than in the control group (P<0.05). When the optimum cut-off point of vWF:Ag for VTE diagnosis was 192% in the cancer group, the area under ROC curve = 0.828 (95% CI: 0.716 to 0.939). When the optimum cut-off point of D-dimer for VTE diagnosis was 1484 ng/ml in the cancer group, the area under ROC curve = 0.915 (95% confidence interval: 0. 840 to 0.988). When the optimum cut-off point of PC: A for VTE diagnosis was 75.2% in the cancer group, the area under ROC curve = 0.764 (95% confidence interval: 0.630 to 0.898). The Cox analysis showed that age, surgery, chemotherapy and D-dimer were independent risk factors for VTE event within three months in cancer patients. The cumulative probability of VTE was increased significantly in the cancer patients if whose plasma D-dimer level was over the cut-off value.
  
  
  CONCLUSIONS
  The plasma D-dimer level is obviously increased in cancer patients, and there is a relevance to thrombosis risk stratification and VTE cumulative probability. It is with good diagnostic performance, and may be used as an effective marker in estimation of VTE risk within 3 months in cancer patients.
authors.forename: Men
authors.initials: M
authors.lastname: Jianlong
authors.forename: Zhong
authors.initials: Z
authors.lastname: Diansheng
authors.forename: Ren
authors.initials: R
authors.lastname: Jing
mesh_terms: D000368:Aged; D000991:Antithrombins / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005167:Factor VII / Q000032:analysis; D005169:Factor VIII / Q000032:analysis; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood*; D011379:Prognosis; D011486:Protein C / Q000032:analysis; D017293:Protein S / Q000032:analysis; D012372:ROC Curve; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000209:etiology*; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D000991:Antithrombins; D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; D017293:Protein S; C036309:fibrin fragment D; D014841:von Willebrand Factor; C427184:recombinant factor VIII SQ; D005167:Factor VII; D005169:Factor VIII