Blood clotting activation analysis for preoperative differentiation of benign versus malignant ovarian masses
| Autor: | Hina Desai, Alane Waters, Mildred Rivera-Amaya, John L. Francis, Todd Meyer, Glenn Bigsby, Liza Robles-Carrillo, Ali Amirkhosravi, Florian Länger, Enriqueta Coll, Enriquo Reyes, Patricia Faust |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Pathology medicine.medical_specialty Sensitivity and Specificity Thromboplastin Flow cytometry Diagnosis Differential Fibrin Fibrinogen Degradation Products Tissue factor Biomarkers Tumor Humans Medicine Blood Coagulation Aged Ovarian Neoplasms Hemostasis Blood clotting medicine.diagnostic_test business.industry Fibrinogen Hematology General Medicine Middle Aged Clot formation medicine.disease Thromboelastography Thrombelastography Coagulation CA-125 Antigen Preoperative Period Female business Ovarian cancer |
| Zdroj: | Blood Coagulation & Fibrinolysis. 24:510-517 |
| ISSN: | 0957-5235 |
| DOI: | 10.1097/mbc.0b013e32835e63b7 |
| Popis: | Preoperative evaluation of patients presenting with ovarian masses is challenging, partly due to shortcomings with the commonly used marker, CA-125. Ovarian cancer is associated with systemic coagulation activation. Measurement of D-dimer, serum tissue factor (TF), and the coagulation process as a whole are considered candidates for improving discrimination between benign and malignant ovarian masses. We therefore sought to identify possible benefits by analyzing preoperative coagulation status in conjunction with CA-125 in patients with ovarian masses. Preoperative blood from 95 patients with ovarian masses (75 benign, 20 malignant) and 30 controls was analyzed, prospectively. Thromboelastography served for global hemostatic assessment. Plasma TF antigen and D-dimer were measured by ELISA and microparticle-associated TF activity by thrombin generation assay. TF microparticles were enumerated by flow cytometry. Time to clot formation by thromboelastography was similar between patients having either benign or malignant ovarian tumors. Clot formation rate, clot strength, and coagulation index were significantly increased in patients having malignant versus benign tumors, indicating that thromboelastography differentiated malignant from benign tumors. D-dimer alone differentiated malignant from benign ovarian tumors and also improved differentiation when combined with CA-125. Circulating TF antigen, activity, and TF microparticle numbers, however, failed to differentiate benign from malignant tumors. Significant coagulation activation occurs in women with ovarian malignancies. Plasma D-dimer may help discriminate between patients with benign and malignant tumors. Thromboelastography may also contribute meaningfully when combined with CA-125 in the preoperative evaluation of ovarian masses. Larger studies are needed to assess these possibilities. |
| Databáze: | OpenAIRE |
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