Blood clotting activation analysis for preoperative differentiation of benign versus malignant ovarian masses
Standard
Blood clotting activation analysis for preoperative differentiation of benign versus malignant ovarian masses. / Amirkhosravi, Ali; Bigsby, Glenn; Desai, Hina; Rivera-Amaya, Mildred; Coll, Enriqueta; Robles-Carrillo, Liza; Faust, Patricia; Waters, Alane; Meyer, Todd; Reyes, Enriquo; Langer, Florian; Francis, John L.
In: Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis, Vol. 24, No. 5, 01.07.2013, p. 510-7.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Blood clotting activation analysis for preoperative differentiation of benign versus malignant ovarian masses
AU - Amirkhosravi, Ali
AU - Bigsby, Glenn
AU - Desai, Hina
AU - Rivera-Amaya, Mildred
AU - Coll, Enriqueta
AU - Robles-Carrillo, Liza
AU - Faust, Patricia
AU - Waters, Alane
AU - Meyer, Todd
AU - Reyes, Enriquo
AU - Langer, Florian
AU - Francis, John L
PY - 2013/7/1
Y1 - 2013/7/1
N2 - Preoperative evaluation of patients presenting with ovarian masses is challenging, partly due to shortcomings with the commonly used marker, CA-125. Ovarian cancer is associated with systemic coagulation activation. Measurement of D-dimer, serum tissue factor (TF), and the coagulation process as a whole are considered candidates for improving discrimination between benign and malignant ovarian masses. We therefore sought to identify possible benefits by analyzing preoperative coagulation status in conjunction with CA-125 in patients with ovarian masses. Preoperative blood from 95 patients with ovarian masses (75 benign, 20 malignant) and 30 controls was analyzed, prospectively. Thromboelastography served for global hemostatic assessment. Plasma TF antigen and D-dimer were measured by ELISA and microparticle-associated TF activity by thrombin generation assay. TF microparticles were enumerated by flow cytometry. Time to clot formation by thromboelastography was similar between patients having either benign or malignant ovarian tumors. Clot formation rate, clot strength, and coagulation index were significantly increased in patients having malignant versus benign tumors, indicating that thromboelastography differentiated malignant from benign tumors. D-dimer alone differentiated malignant from benign ovarian tumors and also improved differentiation when combined with CA-125. Circulating TF antigen, activity, and TF microparticle numbers, however, failed to differentiate benign from malignant tumors. Significant coagulation activation occurs in women with ovarian malignancies. Plasma D-dimer may help discriminate between patients with benign and malignant tumors. Thromboelastography may also contribute meaningfully when combined with CA-125 in the preoperative evaluation of ovarian masses. Larger studies are needed to assess these possibilities.
AB - Preoperative evaluation of patients presenting with ovarian masses is challenging, partly due to shortcomings with the commonly used marker, CA-125. Ovarian cancer is associated with systemic coagulation activation. Measurement of D-dimer, serum tissue factor (TF), and the coagulation process as a whole are considered candidates for improving discrimination between benign and malignant ovarian masses. We therefore sought to identify possible benefits by analyzing preoperative coagulation status in conjunction with CA-125 in patients with ovarian masses. Preoperative blood from 95 patients with ovarian masses (75 benign, 20 malignant) and 30 controls was analyzed, prospectively. Thromboelastography served for global hemostatic assessment. Plasma TF antigen and D-dimer were measured by ELISA and microparticle-associated TF activity by thrombin generation assay. TF microparticles were enumerated by flow cytometry. Time to clot formation by thromboelastography was similar between patients having either benign or malignant ovarian tumors. Clot formation rate, clot strength, and coagulation index were significantly increased in patients having malignant versus benign tumors, indicating that thromboelastography differentiated malignant from benign tumors. D-dimer alone differentiated malignant from benign ovarian tumors and also improved differentiation when combined with CA-125. Circulating TF antigen, activity, and TF microparticle numbers, however, failed to differentiate benign from malignant tumors. Significant coagulation activation occurs in women with ovarian malignancies. Plasma D-dimer may help discriminate between patients with benign and malignant tumors. Thromboelastography may also contribute meaningfully when combined with CA-125 in the preoperative evaluation of ovarian masses. Larger studies are needed to assess these possibilities.
KW - Adult
KW - Aged
KW - Blood Coagulation
KW - CA-125 Antigen
KW - Diagnosis, Differential
KW - Female
KW - Fibrin Fibrinogen Degradation Products
KW - Fibrinogen
KW - Hemostasis
KW - Humans
KW - Middle Aged
KW - Ovarian Neoplasms
KW - Preoperative Period
KW - Sensitivity and Specificity
KW - Thrombelastography
KW - Thromboplastin
KW - Tumor Markers, Biological
U2 - 10.1097/MBC.0b013e32835e63b7
DO - 10.1097/MBC.0b013e32835e63b7
M3 - SCORING: Journal article
C2 - 23406663
VL - 24
SP - 510
EP - 517
JO - BLOOD COAGUL FIBRIN
JF - BLOOD COAGUL FIBRIN
SN - 0957-5235
IS - 5
ER -
