Peripheral Blood Plasminogen Activator Inhibitor 1 and Tissue-Type Plasminogen Activator-Inhibitor Complex Levels for the Diagnosis and Prediction Value of Venous Thromboembolism in Malignant Tumors.

Abstract

Patients with malignant tumors complicated by venous thromboembolism (VTE) face high mortality rates because of a lack of effective diagnostic and predictive markers. Plasminogen activator inhibitor 1 (PAI-1) and tissue-type plasminogen activator-inhibitor complex (t-PAIC) may contribute to VTE formation in these patients. To evaluate the diagnostic and predictive value of peripheral blood PAI-1 and t-PAIC levels in patients with malignant tumors complicated by VTE and to develop a new thrombosis risk score model (NRS) based on PAI-1 levels. This study included 216 patients with malignant tumors (lung, colorectal, ovarian, breast, and gastric cancers). The correlation between PAI-1 and t-PAIC levels was explored. The predictive value of PAI-1 and t-PAIC, combined with the COMPASS-CAT risk score, Khorana risk score, and Padua risk score, was assessed for postoperative VTE risk. Differences in PAI-1 and t-PAIC levels across tumor types were also analyzed. The PAI-1 and t-PAIC levels were positively correlated. Preintervention PAI-1 levels independently predicted VTE risk, and the new thrombosis risk score model could effectively predict the occurrence of concurrent VTE in patients with malignancy. PAI-1 and t-PAIC have better diagnostic value for VTE than D-dimers. Combining these markers with the COMPASS-CAT risk score, Khorana risk score, and Padua risk score improves the risk prediction of VTE. PAI-1 levels were significantly associated with VTE risk in colorectal cancer, whereas t-PAIC levels were significantly associated with VTE risk in breast cancer. Peripheral blood PAI-1 and t-PAIC levels have excellent predictive and diagnostic value for VTE in patients with malignancy.