Correlation Between The Number Of Nucleated Cells And Coagulation Function In Plasma And Hypercoagulable State Of Malignant Tumors

Objective: To prove that the Khorana risk predictive model is not sufficient to predict the hypercoagulable state of patients with malignant tumors.Analyze blood routine and coagulation function parameters of patients with malignant tumors,and study the correlation between the number of plasma nucleated cells and coagulation function and tumor hypercoagulability status.Screening can be used as a predictor of tumor hypercoagulability status and provide a theoretical basis for the establishment of tumor hypercoagulability status prediction model.Methods:1.Through retrospective analysis,1524 hospitalized patients who were diagnosed as malignant tumors by histopathology from January 2,2018 to September 9,2019 in the Fourth Hospital of Hebei Medical University were selected,and the clinical diagnosis and height of the patients,body weight,blood routine and coagulation function test results before anti-tumor treatment after admission,and the information on whether deep vein thrombosis(VTE)are combined were collected.Establish a database,24 patients with malignant tumors combined with deep vein thrombosis and 1500 patients without signs of thrombosis were screened out.The Khorana score was used to score each patient,and the cases were grouped according to different scores.The SPSS24.0 statistical analysis software was used to prove that the difference in the incidence of thrombosis in different groups is not statistically significant,which proves that the Khorana score is not sufficient for malignant tumor patients to predict the hypercoagulable state.2.All enrolled patients were divided into two groups: "simple malignant tumor group" and "malignant tumor combined with deep vein thrombosis(VTE)group".The blood routine and coagulation function indexes of the two groups of patients were sequentially compared whether there were significant differences,and the indexes with significant differences were screened out.Then,the indicators with significant differences were grouped according to "normal indicators" and "abnormal indicators",and the spss24.0 statistical software was used to analyze the correlation between thrombosis and abnormal indicators,and the two related indicators were screened out.A binary logistic regression model was used to analyze whether the relevant indicators were risk factors for malignant tumors with deep vein thromboembolism.Results: 1.The relationship between Khorana score and thrombosis:There was no significant difference in the incidence of thrombosis between 0points and 3 groups,and 1 and 2 groups(P>0.05);2.Patients with malignant tumors combined with deep vein thrombosis and simple malignancy Comparison of tumor patients showed that there are statistical differences in monocyte count,hemoglobin,hematocrit,average red blood cell volume,average red blood cell hemoglobin content,prothrombin activity,platelet distribution width,prothrombin time,and international standardized ratio.There was no significant statistical difference in other indicators.3.Two-class logistic regression model analysis found that prothrombin activity(OR=1.053)and hemoglobin(OR=1.031)were independent risk factors for malignant tumors with deep vein thrombosis.Conclusions:1.The Khorana score is not enough to predict the hypercoagulable state of cancer patients,and other factors need to be supplemented to improve the risk assessment model.2.Prothrombin activity and hemoglobin are independent risk factors for malignant tumors with deep vein thrombosis.3.Some patients with malignant tumors and deep vein thrombosis have no obvious abnormal changes in blood routine and coagulation function indicators,which may be related to the tumor type,the number of treatment cycles,the duration of thrombosis and the treatment plan,and some patients may have asymptomatic thrombosis.Clinically,there is an urgent need for a more sensitive thrombosis risk assessment model,and attention should be paid to clinical signs and imaging examinations related to thrombus in patients.