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| Application of molecular markers of endothelial cell injury in patients with malignant tumor organ failure |
| Zhou Kun,Suo Bing,Li Yanli,Gao Qingfeng,Wu Caiyu |
| Beidahuang Industry Group General Hospital Department of Clinical Laboratory Harbin 150088 HeiLongjiang China |
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Abstract Objective To evaluate the application value of quick sequential organ failure score qSOFA soluble thrombomodulin
sTM tissue plasminogen activator- inhibitor complex t-PAIC in patients with malignant multiple organ failure MOF . Method
A retrospective analysis was performed on 240 patients diagnosed with malignant tumor in our hospital including 125 patients without
organ failure and 115 patients with multiple organ failure MOF . Mann-Whitney U test was used to compare the two groups and
binary Logistics regression was used to analyze the relationship between sTM t-PAIC and MOF in malignant tumor patients. The
receiver operating characteristic curve ROC determines the diagnostic efficiency of each index and the maximum Youden index is
taken as the best cutoff value. Survival curve was plotted by Kaplan-Meier method to analyze the difference of survival rate among
different groups. Result The 60-day mortality qSOFA score SOFA score sTM t-PAIC of malignant tumor patients with MOF were
significantly higher than those without organ failure group the difference was statistically significant P < 0. 001 . Binary Logistic
regression analysis showed that sTM and t - PAIC were significantly correlated with MOF in patients with malignant tumors OR =
1. 750 1. 185 P<0. 001 P = 0. 003 . ROC curve analysis results showed that the cutoff values of qSOFA sTM and t-PAIC for
predicting MOF in malignant tumor patients were 2 27. 40 kU/ L and 18. 65 μg / L respectively and the area under curve AUC
were 0. 815 0. 848 and 0. 824 respectively. The combined diagnosis efficiency of sTM + t-PAIC was the highest and the AUC was
0. 881. Patients with qSOFA≥2 sTM≥27. 40 kU/ L t-PAIC≥18. 65 μg / L were taken as the high level group and those with less
than cutoff value were taken as the low level group. Kaplan-Meier analysis results showed that the overall survival rate of patients with
high level qSOFA sTM t-PAIC was significantly reduced. The difference was statistically significant P = 0. 021 P< 0. 001 P<0. 001 . Conclusion In malignant tumor patients with MOF plasma sTM and t-PAIC levels were significantly increased and were
significantly correlated with the prognosis of patients. It is suggested that sTM and t-PAIC should be included in the scoring criteria of
SOFA or qSOFA or used as auxiliary diagnosis of SOFA or qSOFA. Early intervention of malignant tumor patients with MOF can
improve the short-term prognosis of tumor patients through non-invasive and rapid laboratory detection.
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Received: 06 April 2022
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