Novel haemostatic markers for thromboembolic risk in patients with prostate cancer
Mazen Toukh,1 Angela Black, 2 Sylvia Robb,2 D. Robert Siemens,1,2 Maha Othman1
1Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Ontario, Canada
2 Department of Urology, Queen’s University, Kingston General Hospital
Abstract
Objectives: To investigate the role of Thromboelastography (TEG) in assessing hemostatic status of patients with various stages of prostate cancer under different systemic therapies and to investigate whether TEG and/ or plasma procoagulant microparticles can help identification of those with higher risk for developing thromboembolic complications.
Methods: We studied 36 patients diagnosed with prostate cancer aged 58-88 years and 8 age and sex matched controls. With the exclusion of 4 patients for being on anticoagulant prophylaxis, 32 patients were divided according to their cancer status and line of management into: group A: watchful wait (11 patients), group B: androgen deprivation therapy (10 patients) and group C: castration resistant cancer (CRPC) (11 patients). We performed thromboelastography using citrated recalcified whole blood samples and flow cytometry analysis of plasma tissue factor- carrying procoagulant microparticles (TF-MPs) using FITC- Annexin V and PE-anti-human tissue factor antibodies.
Results: Overall, 81% of patients showed hypercoagulable TEG traces. One way ANOVA showed significant difference in groups B and C with respect to R time and coagulation index CI values (P< 0.05). Plasma TF- MPs were significantly elevated in patients compared to the control (P = 0.014) with significant variations in groups B and C (P< 0.05). Prostate specific antigen (PSA) was found to be correlated with hypercogulability with a significant reversed correlation with each of CI (r= -0.535; P= 0.012) and TF-MPs (r= -0.38; P= 0.035) and a significant direct correlation with R time (r=0.449; P= 0.011).
Conclusion: To our knowledge, this is the first report to assess TEG and procoagulant plasma microparticles in relation to different stages of prostate cancer and to correlate these markers to PSA levels.TEG and TF-MPs have potential to help risk stratification and may guide towards the use of anticoagulant prophylaxis in patients with prostate cancer.
|
|||||||||||||||||||||||||||||||||||||||||||||
|
|
|||||||||||||||||||||||||||||||||||||||||||||
