Application of Thromboelastography to Predict Lung Cancer Stage

Abstract

Objective: Lung cancer is often associated with hypercoagulability. Thromboelastography provides integrated information on clot formation in whole blood. This study explored the possible relationship between thromboelastography and lung cancer. Methods: Lung cancer was staged according to the Tumor, Node, and Metastasis (TNM) classification system. Thromboelastography parameters in different stages of disease were compared. The value of thromboelastography for stage prediction was determined by area under the receiver operating characteristic curve analysis. Results: A total of 182 patients diagnosed with lung cancer were included. Thromboelastography parameters, including kinetics time, α-angle, and maximum amplitude, differed significantly between patients with metastatic and limited lung cancers ( P < 0.05). Kinetics time was significantly reduced and maximum amplitude was significantly increased in patients with stage I and II compared with stage III and IV tumors ( P < 0.05). TNM stage was significantly negatively correlated with kinetics time ( r = −0.186), and significantly positively correlated with α-angle ( r = 0.151) and maximum amplitude ( r = 0.251) (both P < 0.05). The area under the curve for kinetics time in patients with stage I cancer was 0.637 ( P < 0.05) and that for α-angle in stage ≥ II was 0.623 ( P < 0.05). The areas under the curves for maximum amplitude in stage ≥ III and stage IV cancer were 0.650 and 0.605, respectively (both P < 0.05). Thromboelastography parameters were more closely associated with TNM stage in patients with lung adenocarcinoma than in the whole lung cancer population. Conclusion: This study identified the diagnostic value of thromboelastography parameters for determining tumor stage in patients with lung cancer. Thromboelastography can be used as an independent predictive parameter for lung cancer severity.

Risk Factors and Impact on Outcomes of Lung Cancer Patients Concurrent with Deep Vein Thrombosis

“…Lung cancer patients often suffer from blood hypercoagulation and alterations in blood coagulation. 4 Cancer can increase coagulability and the release of procoagulant microparticles into the circulation, 5 which may lead to an increased incidence of thromboembolic disease. Furthermore, transient risk factors, such as surgery, trauma, acute infection, and hospitalization, can significantly increase the risk of cancer-associated thrombosis.…”

Hypercoagulability and Thrombosis Risk in Prostate Cancer: The Role of Thromboelastography

“…- Kinetics time and MA differed significantly between those with stage I and II vs. stage III and IV tumors ( p < 0.05) 46…”

“…- TEG parameters more closely associated with tumor, node, and metastasis stage in patients with lung adenocarcinoma than in the entire lung cancer population 46…”

“…- TEG parameters significantly different between patients with metastatic and limited lung cancer ( p < 0.05) 46…”

“…37 Together with platelet count greater than 50,000, normal TEG was able to predict survival in cancer patients with suspected coronary artery disease 45 and can be an independent predictive parameter for severity in lung cancer and also cancer progression as evidenced by node, and metastasis in lung adenocarcinoma than in the entire lung cancer population. 46 In gynecological cancers, there has been some contradictory findings. Presurgical/basal TEG showed changes only in α-angle between benign or premalignant disease, 47 while Wehrum et al found significant differences in four TEG parameters between patients and controls.…”