背景:静脉血栓栓塞症(VTE),是胃癌患者值得注意的并发症,但目前的诊断和治疗方法缺乏准确性。在这项研究中,我们开发了一种t-PAIC化学发光试剂盒,并使用化学发光来检测组织纤溶酶原激活物抑制剂复合物(t-PAIC),凝血酶-抗凝血酶III复合物(TAT),纤溶酶-α2-纤溶酶抑制剂复合物(PIC)和血栓调节蛋白(TM),结合D-二聚体和纤维蛋白降解产物(FDP),探讨其对胃癌患者静脉血栓形成的诊断潜力。该研究评估了不同阶段胃癌患者中六个指标的变化。
结果:t-PAIC试剂显示LOD为1.2ng/mL,线性因子R大于0.99。试剂显示出准确的结果,所有精度偏差在5%以内。t-PAIC试剂的批内和批间CV均在8%以内。该方法与Sysmex之间的相关系数R为0.979。胃癌患者TAT水平升高,PIC,TM,D-D,FDP与健康人群相比,而t-PAIC没有观察到显著差异。在胃癌的分期中,与I-II期患者相比,III-IV期患者的6种标志物水平更高.ROC曲线表明四个或六个指标联合诊断的敏感性和特异性增强。
结论:我们的化学发光测定法与Sysmex的方法相当,并且成本较低。使用多个标记,包括t-PAIC,TM,TAT,PIC,D-D,FDP,在恶性肿瘤患者中诊断VTE优于使用单一标志物。应筛查胃癌患者的六种标志物,以促进积极预防。确定最合适的治疗时机,改善他们的预后,减少静脉血栓形成和死亡率的发生,延长他们的生存。
BACKGROUND: Venous thromboembolism (VTE), is a noteworthy complication in individuals with gastric cancer, but the current diagnosis and treatment methods lack accuracy. In this study, we developed a t-PAIC chemiluminescence kit and employed chemiluminescence to detect the tissue plasminogen activator inhibitor complex (t-PAIC), thrombin-antithrombin III complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC) and thrombomodulin (TM), combined with D-dimer and fibrin degradation products (FDP), to investigate their diagnostic potential for venous thrombosis in gastric cancer patients. The study assessed variations in six indicators among gastric cancer patients at different stages.
RESULTS: The t-PAIC reagent showed LOD is 1.2 ng/mL and a linear factor R greater than 0.99. The reagents demonstrated accurate results, with all accuracy deviations being within 5%. The intra-batch and inter-batch CVs for the t-PAIC reagent were both within 8%. The correlation coefficient R between this method and Sysmex was 0.979. Gastric cancer patients exhibited elevated levels of TAT, PIC, TM, D-D, FDP compared to the healthy population, while no significant difference was observed in t-PAIC. In the staging of gastric cancer, patients in III-IV stages exhibit higher levels of the six markers compared to those in I-II stages. The ROC curve indicates an enhancement in sensitivity and specificity of the combined diagnosis of four or six indicators.
CONCLUSIONS: Our chemiluminescence assay performs comparably to Sysmex\'s method and at a reduced cost. The use of multiple markers, including t-PAIC, TM, TAT, PIC, D-D, and FDP, is superior to the use of single markers for diagnosing VTE in patients with malignant tumors. Gastric cancer patients should be screened for the six markers to facilitate proactive prophylaxis, determine the most appropriate treatment timing, ameliorate their prognosis, decrease the occurrence of venous thrombosis and mortality, and extend their survival.