Assessment of hypercoagulability using thromboelastography predicts advanced status in renal cell carcinoma

J Clin Lab Anal. 2020 Jan;34(1):e23017. doi: 10.1002/jcla.23017. Epub 2019 Aug 22.

Abstract

Background: Thromboelastography (TEG) has been established as a sensitive method to assess the whole coagulation process. The aim of the study was to evaluate the diagnosis significance of TEG on hypercoagulability in patients suffering renal mass.

Methods: A total of 478 patients were diagnosed with renal tumor by histolopathologic examination and were assigned to three groups. Group A: 79 patients with benign renal tumor; Group B: 317 patients with renal cell carcinoma (RCC, Fuhrman grades I and II); Group C: 82 patients with high-risk RCC (Fuhrman grades III and IV). Subgroup analysis was performed in malignant renal tumor patients according to the TMN classification. The clinical data, whole blood TEG, and conventional coagulation tests were reviewed.

Results: There was no statistically significant difference between subgroups in respect to conventional coagulation tests. Hypercoagulablity was marked in Group C according to the TEG parameters. The elevated platelets and fibrinogen is linked with hypercoagulability in renal tumor. The positive correlation was between fibrinogen and MA value (r = .663, P < .05). The pathologic tumor stages were also associated with the TEG parameters.

Conclusion: Patients suffering advanced RCC are hypercoagulable which can be identified by TEG. MA value could be potential diagnosis indicators for detecting high-grade RCC.

Keywords: advanced status; conventional coagulation tests; hypercoagulablity; renal cell carcinoma; thromboelastography.

MeSH terms

  • Blood Coagulation
  • Carcinoma, Renal Cell / blood*
  • Carcinoma, Renal Cell / pathology*
  • Female
  • Humans
  • Kidney Neoplasms / blood*
  • Kidney Neoplasms / pathology*
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Neutrophils / pathology
  • Thrombelastography*
  • Thrombophilia / blood
  • Thrombophilia / diagnosis*
  • Thrombophilia / diagnostic imaging*