Abstract:

Objective To understand the pattern of coagulation function change in colon cancer patients and colon polyp patients，and to investigate the clinical application value of thromboelastography（TEG） and conventional coagulation tests（CCT） in evaluating coagulation function and predicting thrombosis in colon cancer patients. Methods Totally，128 patients with colon cancer，147 patients with colon polyps in Shanghai Tenth People's Hospital of Tongji University from May 2018 to May 2019 were enrolled. A total of 60 patients with healthy subjects were enrolled as control group. The determinations of TEG [coagulation reaction time（R），coagulation formation time（K），alpha angle（α-Angle），maximum amplitude（MA） and coagulation index（CI）]，CCT [prothrombin time（PT），fibrinogen（Fib），activated partial thromboplastin time（APTT），thrombin time（TT） and D-dimer（DD）] and platelet（PLT） count were performed，and the differences between the 2 groups were observed. Receiver operating characteristic（ROC） curve was used to evaluate the performance of each indicator for blood hypercoagulable state in colon cancer and colon polyp patients. Results The 67.19% of patients with colon cancer and 34.69% of patients with colon polyps had a blood hypercoagulable state. Compared with control group，R，K，PT，APTT，TT and PLT count were decreased（P<0.01），and α-Angle，MA，CI，Fib and DD were increased in colon cancer group（P<0.01）. Compared with colon polyp group，R，K，APTT，TT and PLT count in colon cancer group were decreased（P<0.05），and α-Angle，CI，Fib and DD were increased（P<0.05）. MA and CI were increased in colon polyp group compared with control group（P<0.05）. The evaluation performance for blood hypercoagulable state in colon cancer group was optimal with CCT，with an area under curve of 0.863，a sensitivity of 68.8% and a specificity of 92.3%. That for blood hypercoagulable state in colon polyp group was optimal with TEG，with an area under curve of 0.726，a sensitivity of 70.3% and a specificity of 61.5%. Conclusions TEG and CCT are complementary in the evaluation of coagulation function and can not be replaced by each other，which play roles in clinic.

Key words: Thromboelastography, Conventional coagulation test, Platelet count, Colon Cancer, Colon polyp