Coagulation parameters for the differential diagnosis of pancreatic cancer in the early stage: a retrospective study

European Journal of Medical Research

Research

Li Jiaao¹  Peng Yunpeng²  Zhang Kai²  Ge Wanli²  Guo Feng² 

[1] Kangda College, Nanjing Medical University, 101 Longmian Road, 210000, Nanjing, Jiangsu, People’s Republic of China;Pancreas Center, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, Jiangsu, People’s Republic of China;Pancreas Institute, Nanjing Medical University, 210029, Nanjing, Jiangsu, People’s Republic of China;

关键词: Pancreatic cancer;    Coagulation parameters;    Diagnosis;    Early diagnosis;   

DOI  :  10.1186/s40001-023-01379-x

 received in 2023-02-23, accepted in 2023-09-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn recent years, conventional coagulation (CC) and thromboelastography (TEG) parameters have been reported to be closely related to the progression of pancreatic cancer (PC). However, the potential utility of these parameters in differentiating benign and malignant pancreatic diseases is still unclear.ObjectivesA retrospective study was conducted to evaluate the efficacy of coagulation parameters in differentiating pancreatic cancer/early stage pancreatic cancer (EPC, TNM stages I and II) from benign control conditions, and to further explore whether coagulation parameters could improve the differential value of CA199.MethodsReceiver operating characteristic (ROC) curves and logistic regression analysis were used to identify the diagnostic value of each coagulation parameter or combination of parameters.ResultsCompared with benign pancreatic disease (BPD), patients with pancreatic malignant tumors had significant coagulation disorders, specifically manifested as abnormal increases or decreases in several CC and TEG parameters (such as activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (DD2), K time, R time, Angle, maximum amplitude (MA), coagulation index (CI), and Ly30). In the training group, ROC curve showed that FIB, DD2, Angle, MA, and CI had favorable efficacy at differentiating PC or EPC from BPD (for PC, AUC = 0.737, 0.654, 0.627, 0.602, 0.648; for EPC, AUC = 0.723, 0.635, 0.630, 0.614, 0.648). However, several combined diagnostic indicators based on FIB, DD2 and CI failed to outperform the individual coagulation indexes in diagnostic efficiency. Combinations of certain coagulation indexes with CA199 outperformed CA199 alone at identifying PC or EPC, especially FIB + CA199 (for PC, AUC = 0.904; for EPC, AUC = 0.905), FIB + DD2 + CA199 (for PC, AUC = 0.902; for EPC, AUC = 0.900), FIB + CI + CA199 (for PC, AUC = 0.906; for EPC, AUC = 0.906), and FIB + DD2 + CI + CA199 (for PC, AUC = 0.905; for EPC, AUC = 0.900). The results from a validation set also confirmed that these combinations have advantageous diagnostic value for PC and EPC.ConclusionsA significant hypercoagulable state was common in PC. Some CC and TEG parameters are valuable in the differential diagnosis of benign and malignant pancreatic diseases. In addition, coagulation indexes combined with CA199 can further enhance the differential diagnosis efficacy of CA199 in PC and EPC.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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