COAGULATION BIOMARKER
STG-ThromboScreen test kit, further increasing the standardisation of results.
Thrombin peak shown to indicate E-DR A decrease of lag time and time to peak (TTP) and an increase in peak value had already been shown to predict the presence of breast cancer in an earlier case-control study.10
Furthermore,
the study group had already internally validated the role of ETP within a risk assessment model for disease return. The study now formally sought to confirm its own disease recurrence observations by running pre- chemotherapy parameters of TG on the ST Genesia (Fig 2).
These showed that in the absence of TM, patients showed significantly higher thrombin peak and ETP compared with controls. Endogenous thrombin potential provides insight into the balance between pro- and anticoagulant elements when investigating hyper- and hypocoagulability (Table 2). When TM was present, a significantly lower inhibition of ETP and peak was observed compared with controls. Early disease recurrence was seen in 28 patients with a significantly higher peak and ETP in the absence of TM, compared with disease-free patients.
b a
100 80 60 40 20 0
100 80 60 40 20 0
DF Peak inhibition P <0.001
100 80 60 40 20 0
Control Patients
Peak inhibition P <0.001
100 80 60 40 20 0
E-DR DF
Fig 2. Endogenous thrombin generation potential inhibition and peak inhibition a) in patients compared with controls, and b) in patients with E-DR compared with DF.8
Significance of raised ETP The comparison of TG parameters between E-DR and disease-free (DF) patients showed significantly elevated ETP and peak values compared to those without disease, with no differences observed in ETP and peak inhibition by TM.
Independent risk factors for E-DR were
identified by the multivariable analysis as ETP values (absolute and normalised), triple-negative (TN), luminal B HER2- negative molecular subtypes and mastectomy. The coefficient of these parameters was used to create two separate risk assessments, one based on ETP absolute values and the second on normalised ETP (nETP) values. The good
ETP inhibition P <0.001
Control
Patients
ETP inhibition P <0.001
E-DR
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Inhibition (%)
Inhibition (%)
Inhibition (%)
Inhibition (%)
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