Clinical association between coagulation indicators and bone metastasis in patients with gastric cancer

BACKGROUND Bones are one of the most common target organs for cancer metastasis.Early evaluation of bone metastasis(BM)status is clinically significant.Cancer patients often experience a hypercoagulable state.AIM To evaluate the correlation between coagulation indicators and the burden of BM in gastric cancer(GC).METHODS We conducted a single-center retrospective study and enrolled 454 patients.Clinical information including routine blood examination and coagulation markers were collected before any treatment.Patients were grouped according to the status of BM.Receiver operating characteristic curves were used to assess diagnostic performance and determine the optimal cutoff values of the above indicators.Cutoff values,sensitivity and specificity were based on the maximum Youden index.Univariate and multivariate logistic regression analyses were used to evaluate the relationships between biomarkers and BM.RESULTS Of the 454 enrolled patients,191 patients were diagnosed with BM.The receiver operating characteristic curve analysis suggested that prothrombin time(PT)Wang X et al.Coagulation indicators predict bone metastasis WJGO https://www.wjgnet.com 1254 July 15,2023 Volume 15 Issue 7[cutoff:13.25;sensitivity:0.651;specificity:0.709;area under receiver operating characteristic curve(AUC)=0.738],activated partial thromboplastin time(aPTT)(cutoff:35.15;sensitivity:0.640;specificity:0.640;AUC=0.678)and fibrin degradation products(FDP)(cutoff:2.75;sensitivity:0.668;specificity:0.801;AUC=0.768)act as novel predictors for BM.Based on multivariate logistic regression analysis,the results showed the independent correlation between PT[odds ratio(OR):3.16;95%confidence interval(CI):1.612-6.194;P=0.001],aPTT(OR:2.234;95%CI:1.157-4.313;P=0.017)and FDP(OR:3.17;95%CI:1.637-6.139;P=0.001)and BM in patients with GC.Moreover,age,carcinoembryonic antigen,erythrocyte and globulin were found to be significantly associated with BM.CONCLUSION Coagulation markers,namely PT,aPTT and FDP,might be potential predictors for screening BM in patients with GC.

Prolonged prothrombin time at admission predicts poor clinical outcome in COVID-19 patients

BACKGROUND Supported by the National Natural Science Foundation of China,No.The prognostic value of coagulation disorder in coronavirus disease 2019(COVID-19)patients should be demonstrated.AIM To investigate the abnormalities of coagulation parameters in the patients with COVID-19 and their prognostic values.METHODS Consecutive patients admitted in the isolation ward of Renmin Hospital of Wuhan University from January 31 to February 5,2020 with confirmed COVID-19 were included.The primary outcomes were death and survival as of March 11.Demographics,vital signs,comorbidities and laboratory tests were collected and compared between those who died and survivors.Logistic regression analysis for prognostic factors was performed.Kaplan-Meier analysis was used to compare the estimated survival rate between patients with prolonged prothrombin time and normal prothrombin time.RESULTS The total number of patients with confirmed COVID-19 who were enrolled was 213.The median age was 62 years,and 95 patients(44.6%)were men.Fifty-one patients were critical(23.9%),79 patients were severe(37.1%)and 83 patients were moderate(39%).As of March 11,2020,99 patients were discharged(46.5%),79 patients(37.1%)stayed in the hospital and 35 patients(16.2%)died.Median time to death was 6(4-8)d,while median hospital stay was 32(22-36)d in survivors(P<0.001).More men(P=0.002)and elderly patients(P<0.001)were found in the group of those who died.The respiration rate at admission was higher in the group of those who died(P<0.001).The incidences of hypertension(P=0.028),cerebrovascular disease(P<0.001),chronic kidney disease(P=0.02)and chronic obstructive pulmonary disease(P<0.001)were higher in the group of those who died.Platelet count was decreased in the group of those who died(P=0.002)whereas prothrombin time(P<0.001),activated partial thromboplastin time(P=0.033),concentration of D-dimer(P<0.001)and fibrin degradation products(P<0.001)were increased in the group of those who died.Prothrombin time[odds ratio(OR):2.19,P=0.004],respiration rate(OR:1.223,P<0.001),age(OR:1.074,P<0.001)and fibrin degradation products concentration(OR:1.02,P=0.014)were predictors of death.The survival rate was significantly lower in patients with prolonge CONCLUSION Prothrombin time,concentration of fibrin degradation products,respiration rate and age were predictive factors for clinical outcomes of COVID-19 patients.

Clinical significance of plasma D-dimer and von Willebrand factor levels in patients with ulcer colitis

AIM: To investigate the levels of D-dimer(DD) and von Willebrand factor(vWF) and the relationship between DD and vWF in ulcerative colitis(UC) patients. METHODS: A total of 29 plasma specimens were obtained from patients with ulcerative colitis (male 13, female 16) aged 21-47 years (33+/-11). Disease activity was assessed by Truelove-Writeria. Patients with a score of above 5 were regarded as having active colitis. Twenty healthy people(male 12, female 8) aged 19-53 years(31+/-14) served as normal controls. Blood samples were taken from an antecubital vein puncture. Blood(1.8 mL) was injected into the tubes containing sodium citrate (0.13 mmol/L). The plasma was obtained by centrifugation at 3000 r.min(-1) for 10 min, and stored at -80 degrees until assayed by ELISA. RESULTS: The mean plasma levels of DD and vWF in active UC patients were significantly higher than those of the controls (0.69+/-0.41 vs 0.27+/-0.11, P【0.01 143+/-46 vs 103+/-35, P【0.01). The mean plasma levels of DD in the patients with active disease were higher than those with inactive disease(0.69+/-0.41 vs 0.48+/-0.29 P【0.05). The levels of vWF were not different between active and inactive patients. DD levels were positively related to vWF levels( r =0.574, P【0.01). There was no significant difference between levels of DD and vWF and the scope of disease and sex of the patients. CONCLUSION: vWF is an important feature and a good marker of UC intravascular thrombus and endothelial cell dysfunction were found in UC patients and the combined test of DD and vWF is helpful to distinguish the activity of the UC patients.