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Coagulation Markers, Neutrophil Extracellular Traps and Thrombin Generation Test, in the Detection and Risk Stratification of Prostate Cancer

J. Oto1, Á. Fernández-Pardo1, E. Plana1, A. Cañada2, F. Cana1, M. Martínez-Sarmiento3, C.D. Vera-Donoso3, F. España1, P. Medina1

1Medical Research Institute Hospital La Fe, Haemostasis, Thrombosis, Atherosclerosis and Vascular Biology Research Group, Valencia, Spain, 2Medical Research Institute Hospital La Fe, Biostatistics Unit, Valencia, Spain, 3La Fe University and Polytechnic Hospital, Department of Urology, Valencia, Spain

Abstract Number: PB1778

Meeting: ISTH 2020 Congress

Theme: Role of Hemostatic System in Cancer, Inflammation and Immunity » Coagulation Proteins Beyond Hemostasis

Background: Cancer patients present coagulation abnormalities that provide the background for an increased tendency of these patients to both thrombosis and hemorrhage. Reciprocally, malignancy affects haemostasis and the hemostatic system affects the tumour biology. Patients with prostate cancer (PCa) paradoxically have both a hypercoagulable state and a bleeding diathesis, and this hypercoagulable state is a reflection of poor prognosis and represents a selective advantage for tumor cells.

Aims: To explore the usefulness of thrombotic markers, neutrophil activation markers and the thrombin generation test (TGT), for the diagnosis and stratification of PCa patients.

Methods: We obtained citrated plasma from 27 locally advanced PCa patients, 51 PCa patients, 18 benign prostatic hyperplasia (BPH) patients and 199 healthy controls. Plasma markers of neutrophil activation (cell-free DNA, myeloperoxidase, nucleosomes and calprotectin) were quantified in PCa and BPH patients and the TGT (CAT, Thrombinoscope) was performed in all samples. Statistical analysis was performed using R (v3.5.0).

Results: We adjusted two elastic net predictive models for PCa classification. The first model, able to discriminate different PCa degrees of severity from BPH patients, included cfDNA, myeloperoxidase, nucleosomes, starttail and lagtime as predictor variables with a validated AUC of 0.68. The second model, able to discriminate PCa and BPH patients from healthy controls, included lagtime, peak, ttPeak, velIndex and startTail as predictor variables with a validated AUC of 0.79.

Conclusions: We propose two models able to distinguish PCa patients of different degrees of severity (locally and non-locally advanced), BPH and healthy controls. Our study highlights the hypercoagulable state found in PCa patients and reinforce the idea of using therapeutic strategies targeting effector molecules of blood coagulation. ISCIII-FEDER (PI14/00079, PI14/00512, FI14/00269, CPII15/00002, PI17/00495), Generalitat Valenciana (ACIF/2017/138) and SETH.

To cite this abstract in AMA style:

Oto J, Fernández-Pardo Á, Plana E, Cañada A, Cana F, Martínez-Sarmiento M, Vera-Donoso CD, España F, Medina P. Coagulation Markers, Neutrophil Extracellular Traps and Thrombin Generation Test, in the Detection and Risk Stratification of Prostate Cancer [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/coagulation-markers-neutrophil-extracellular-traps-and-thrombin-generation-test-in-the-detection-and-risk-stratification-of-prostate-cancer/. Accessed August 15, 2022.

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