Plasmin-Antiplasmin Complex as a New Predictive Marker of Postoperative Venous Thromboembolism in Patients with Gynecologic Malignancy.

Abstract

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 (P = .025, P = .030). D3 after operation, TAT, TM, PIC and t-PAIC levels in malignant tumor group were significantly higher than those in benign tumor group (P < .0001, P = .036, P = .037, P < .0001). PIC level of the VTE group was significantly higher than that of the non-VTE group in malignant patients (P < .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.