Peripheral Blood Plasminogen Activator Inhibitor 1 and Tissue-Type Plasminogen Activator-Inhibitor Complex Levels for the Diagnosis and Prediction Value of Venous Thromboembolism in Malignant Tumors.

Abstract

Context.—: Patients with malignant tumors complicated by venous thromboembolism (VTE) face high mortality rates because of a lack of effective diagnostic and predictive markers. Plasminogen activator inhibitor 1 (PAI-1) and tissue-type plasminogen activator-inhibitor complex (t-PAIC) may contribute to VTE formation in these patients.

Objective.—: To evaluate the diagnostic and predictive value of peripheral blood PAI-1 and t-PAIC levels in patients with malignant tumors complicated by VTE and to develop a new thrombosis risk score model (NRS) based on PAI-1 levels.

Design.—: This study included 216 patients with malignant tumors (lung, colorectal, ovarian, breast, and gastric cancers). The correlation between PAI-1 and t-PAIC levels was explored. The predictive value of PAI-1 and t-PAIC, combined with the COMPASS-CAT risk score, Khorana risk score, and Padua risk score, was assessed for postoperative VTE risk. Differences in PAI-1 and t-PAIC levels across tumor types were also analyzed.

Results.—: The PAI-1 and t-PAIC levels were positively correlated. Preintervention PAI-1 levels independently predicted VTE risk, and the new thrombosis risk score model could effectively predict the occurrence of concurrent VTE in patients with malignancy. PAI-1 and t-PAIC have better diagnostic value for VTE than D-dimers. Combining these markers with the COMPASS-CAT risk score, Khorana risk score, and Padua risk score improves the risk prediction of VTE. PAI-1 levels were significantly associated with VTE risk in colorectal cancer, whereas t-PAIC levels were significantly associated with VTE risk in breast cancer.

Conclusions.—: Peripheral blood PAI-1 and t-PAIC levels have excellent predictive and diagnostic value for VTE in patients with malignancy.