The thrombogenic potential of thrombophilia in malignant tumors of the reproductive system

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Abstract

Objective. To study the significance of genetic and acquired thrombophilia factors in the development of thromboembolic complications (TEC) in patients with pelvic malignancies.

Materials and methods. A retrospective-prospective cohort study with a control group was conducted. It included 546 patients with malignant neoplasms of the pelvic organs, as well as a control group of 137 patients with benign tumors. The patients were divided into three groups: I (n=155) – patients with TEC; II (n=391) – patients without TEC; control group (n=137). Laboratory studies were performed to detect antiphospholipid antibodies (anti-β2-glycoprotein (β2GPI), anti-annexin V, and anti-prothrombin), and genetic tests using PCR were performed to detect FV Leiden, MTHFR C677T, prothrombin G20210A mutations, PAI-1 4G/5G and platelet glycoprotein polymorphisms (GPIIb/IIIa, GPIa/IIa, GPIb, and GP ADP).

Results. Group I was found to have a significantly higher frequency of antiphospholipid antibodies (aPL) circulation (55.8%) and genetic markers of thrombophilia: FV Leiden mutation (20,6%), homozygous MTHFR C677T (41,3%), PAI-1 gene polymorphism (28,4%) and platelet glycoprotein (44,5%). In group II, a moderate frequency of aPL circulation was observed: to β2GPI (13,1%), prothrombin (7,8%) and annexin V (2,6%). The FV Leiden mutation was detected in 9,7% of patients, the homozygous form of the MTHFR C677T in 6,1%, the PAI-1 gene polymorphism in 9,7%, and platelet glycoprotein in 10,2%. In the control group: aPL to β2GPI and annexin V were present in 2,6% of patients, the FV Leiden mutation – in 10,2%, the homozygous form of the MTHFR C677T – in 7,3%, the PAI-1 gene polymorphism – in 10.9% and platelet glycoprotein – in 8,8%.

Conclusion. The study confirmed the significant contribution of genetic and acquired thrombophilia to the development of thrombotic complications in patients with gynaecological cancer. The highest risk was observed in cases involving a combination of genetic mutations and aPL.

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About the authors

A. V. Vorobеv

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: antoninasolopova@yandex.ru
ORCID iD: 0000-0002-4509-9281
SPIN-code: 5806-7062

Associate Professor, Candidate of Medical Science

Russian Federation, Moscow

A. G. Solopova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Author for correspondence.
Email: antoninasolopova@yandex.ru
ORCID iD: 0000-0002-7456-2386
SPIN-code: 5278-0465

Professor, MD

Russian Federation, Moscow

V. O. Bitsadze

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: antoninasolopova@yandex.ru
ORCID iD: 0000-0001-8404-1042
SPIN-code: 5930-0859

MD, Professor of the Russian Academy of Sciences

Russian Federation, Moscow

A. D. Makatsariya

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: antoninasolopova@yandex.ru
ORCID iD: 0000-0001-7415-4633
SPIN-code: 7538-2966

Academician of the Russian Academy of Sciences, MD

Russian Federation, Moscow

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2. Fig. 1. Spectrum of antiphospholipid antibodies

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3. Fig. 2. Spectrum of genetic forms of thrombophilia

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