Objective To explore the value of thromboelastography (TEG) combined with conventional coagulation indicators in evaluating the coagulation function of patients with esophageal cancer and its relationship with prognosis.
Methods A total of 100 patients with esophageal cancer admitted to our hospital from August 2018 to August 2020 were selected as the study subjects. They were divided into study group (hypercoagulable state) and control group (non-hypercoagulable state) according to the presence or absence of venous thrombosis, and further divided into good prognosis group (survival, n=66)and poor prognosis group (death, n=34) according to their prognosis. TEG indicators clot formation time (K), reaction time (R), maximum amplitude (MA), coagulation index (CI), and clot formation rate (Angle) were detected using a TEG instrument; conventional coagulation indicators prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (FIB) were detected using an automatic coagulation analyser; Pearson correlation analysis was used to explore the correlation between TEG indicators and conventional coagulation indicators; logistic regression analysis was used to explore the influencing factors of coagulation function in patients with oesophageal cancer; receiver operating characteristic (ROC) curves were drawn to analyse the value of TEG combined with conventional coagulation indicators in evaluating the coagulation function of patients with esophageal cancer.
Results The K and R values in the study group were shorter than those in the control group, while the MA, CI, and Angle values were larger, with statistically significant differences (P < 0.05). The PT, APTT, and TT values in the study group were shorter than those in the control group, and the FIB level was higher, with statistically significant differences (P < 0.05). According to Pearson correlation analysis, PT, APTT, and TT were positively correlated with K and R, and negatively correlated with MA, CI, and Angle (P < 0.05); FIB was negatively correlated with K, and R and positively correlated with MA, CI, and Angle (P < 0.05). Multivariate logistic regression analysis showed that larger MA, high CI, larger Angle, and high FIB level were risk factors for the coagulation function of patients with esophageal cancer, while longer PT, APTT, TT, K, and R were protective factors (P < 0.05). The ROC curve showed that the area under the curve (AUC) for the combined evaluation of the coagulation function of patients with oesophageal cancer using K, R, MA, CI, Angle, PT, APTT, TT, and FIB was 0.987, which was superior to the evaluation by each indicator alone (P < 0.05). The K, R, PT, APTT, and TT values in the poor prognosis group were shorter than those in the good prognosis group, while the MA, CI, Angle, and FIB levels were larger or higher, with statistically significant differences (P < 0.05).
Conclusion The parameter combination model established by combining TEG with conventional coagulation indicators can improve the evaluation value of the coagulation function and prognosis of patients with oesophageal cancer.
DownLoad: