Occult Cancer in Patients with Unprovoked Venous Thromboembolism: A Nested Case-control Study

Overview

Journal Am J Clin Pathol

Publisher Oxford University Press

Specialty Pathology

Date 2024 Feb 10

PMID 38340336

Authors

Veronica Sanchez-Lopez

Samira Marin-Romero

Marta Ferrer-Galvan

Teresa Elias-Hernandez

Jose Luis Lobo Beristain

Aitor Ballaz Quincoces

Luis Jara-Palomares

Francisco Javier Rodriguez Martorell

Maria Jose Castro

Carmen Marin Hinojosa

Jose Luis Lopez-Campos

Remedios Otero-Candelera

Affiliations

Soon will be listed here.

Abstract

Objectives: Detecting occult cancer in patients with unprovoked venous thromboembolism (VTE) remains a significant challenge. Our objective was to investigate the potential predictive role of coagulation-related biomarkers in the diagnosis of occult malignancies.

Methods: We conducted a nested case-control study with a 1-year prospective cohort of 214 patients with unprovoked VTE, with a focus on identifying occult cancer. At the time of VTE diagnosis, we measured various biomarkers, including soluble P-selectin (sP-selectin), dimerized plasmin fragment D (D-dimer), platelets, leukocytes, hemoglobin, total extracellular vesicles (EVs), EVs expressing tissue factor on their surface (TF+EVs), and EVs expressing P-selectin on their surface (Psel+EVs) in all participants.

Results: We observed statistically significant increased levels of sP-selectin (P = .015) in patients with occult cancer. Despite an increase in Psel+EVs, TF+EVs, D-dimer, and platelets within this group, however, no significant differences were found. When sP-selectin exceeded 62 ng/mL and D-dimer surpassed 10,000 µg/L, the diagnosis of occult cancer demonstrated a specificity of up to 91% (95% CI, 79.9%-96.7%).

Conclusions: The combination of sP-selectin and D-dimer can be a valuable biomarker in detecting occult cancer in patients with unprovoked VTE. Further research is necessary to ascertain whether easily measurable biomarkers such as sP-selectin and D-dimer can effectively distinguish between patients who have VTE with and without hidden malignancies.

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