Platelet Microvesicles as a Predictor of Thromboembolic Complications in Patients With Ovarian Cancer

BACKGROUND: Platelet microvesicles are a promising marker of oncological process activity and dynamics, which allows predicting complications in patients with cancer to guide further management.

AIM: This work aimed to evaluate the role of platelet microvesicles in complication development in patients with ovarian cancer.

MATERIAL AND METHODS: The prognostic role of platelet microvesicles in complication development was studied in 71 patients with ovarian cancer at the Department of Oncology of A.I. Burnasyan Federal Medical Biophysical Center (FMBC, Moscow, 2020–2023). To compare the hemostasis parameters in healthy volunteers and patients with thrombosis, a sample of patients (n = 100) in the Department of Gastric Surgery of A.I. Burnasyan FMBC during the postoperative period and a control group of healthy volunteers (donors from the Department of Blood Transfusion, n = 50) were formed. We performed thromboelastography and determined the general tendency of coagulation, functional activity of platelets and fibrinogen, activity of fibrinolysis and physical and mechanical properties of the formed clots. Platelet aggregation was evaluated using a laser platelet aggregation analyzer. Cytofluorimetric analysis was performed on a standard flow cytometer using specialized software. The obtained data were processed using Statistica 10.0 statistical package. The normality of distribution of the actual data was determined using the Shapiro–Wilk test. The median and interquartile range were used to describe the groups. Analysis of variance was performed using the Kruskal–Wallis (for independent observations) and Friedman (for repeated observations) tests.

RESULTS: Patients with cancer had significantly increased levels of microvesicles in peripheral blood (43.8 × 106 per mL of plasma; p = 0.0001) compared with surgical patients. High levels of microvesicles are accompanied by platelet hyperaggregation: low platelet aggregation rates corresponded to low microvesicle levels (p = 0.001), and patients with fatal thromboembolic complications and patients with ovarian cancer were predominantly in the group with high platelet microvesicle levels (>35 × 106 per mL of plasma, p = 0.0001). When evaluated as a mortality predictor, the level of microvesicles in patients with ovarian cancer was found to have a sensitivity of 61.5% (54.7–82.3) and a specificity of 93.6% (83.5–98.1).

CONCLUSION: Patients with ovarian cancer have high levels of circulating procoagulant microvesicles.