Evaluation Of Haemostatic Molecular Markers For Diagnosis Of DIC In Patients With Three Different Etiologies

Objective: To evaluate the diagnostic value of plasma biomarkers in DIC caused by hematologic malignancy,trauma and infection,and to detect the differences of plasma biomarkers,including TAT,TM,PIC and t-PAI.c.Methods: We enrolled all the 151 patients with suspected DIC among the three underlying diseases from February 1,2018,to December 31,2018 at the First Affiliated Hospital of Nanchang University.The molecular markers were measured by qualitative chemiluminescence enzyme immunoassay performed on HISCL automated analyzers.To detect the plasma levels of TAT,PIC,TM,and t-PAI.c and evaluated their diagnostic performance for DIC in hematologic malignancy,trauma and infection.Results: According to the International Society of Thrombosis and Haemostasis(ISTH)scoring system,52 patients were diagnosed as overt DIC(Patients with DIC scores >5)and 99 were diagnosed as non-overt DIC(Patients with DIC scores <5).There was no statistical difference in age and gender between the overt DIC and the non-overt DIC.All four biomarkers were significantly higher in overt DIC patients than in non-overt DIC patients.The according AUC of them were 0.567,0.889,0.595 and 0.608,respectively.When a combination of the four markers was applied,the AUC increased to 0.904 and the sensitivity to 87.91%.Besides,four molecular markers behaved differently among the three underlying diseases.Among patients with hematologic malignancies,TAT and t-PAI.c levels were significantly higher in the overt DIC than the non-overt DIC(P=0.000,P=0.019).Among the infected patients,TAT,TM,PIC,and t-PAI.c were significantly higher in the overt DIC than the non-overt DIC,which were statistically significant(P=0.014,P=0.003,P=0.003,P=0.034).Among the trauma patients,plasma TM,TAT,and t-PAI.c levels were significantly higher in the overt DIC than the non-overt DIC(P=0.019,P=0.000,P=0.031).There was no statistical difference between the DIC caused by the three underlying diseases for the positive rate of TAT,PIC and t-PAI.c(P=0.234,P=0.081,P=0.12).There was statistical difference in the positive rate of TM between hematologic malignancy group and trauma group(P=0.001).Conclusion: TAT,PIC,t-PAI.c,and TM demonstrated good diagnostic performance and diagnostic value in DIC patients with different underlying diseases.Combination of four makers was demonstrated better behavior than single one.Besides,TAT and t-PAI.c have certain implications in DIC related to hematologic malignancy.TM,TAT,PIC and t-PAI.c have certain implications in DIC caused by infection.Four molecular markers have certain implications in DIC caused by infection.TM,TAT and t-PAI.c can be used for the diagnosis of DIC in traumatic patients.