Changes of international normalized ratio of prothrombin time in patients with early cervical cancer and its predictive value for postoperative lower extremity deep venous thrombosis
Objective To observe the dynamic changes of the international normalized ratio(INR)of prothrombin time in patients with early cervical cancer during the perioperative period,and to analyze the predictive value of INR in predicting postoperative lower extremity deep venous thrombosis(LEDVT).Methods A total of 122 patients with cervical cancer who received modified radical hysterectomy in Suzhou Hospital Affiliated to Nanjing Medical University from February 2019 to January 2023 were prospectively included as the study subjects.They were divided into LEDVT group and N-LEDVT group based on the occurrence of LEDVT within 15 days after surgery.The coagulation indexes[thrombin time(TT),prothrombin time(PT),activated partial prothrombin time(APTT),plasma fibrinogen(FIB),D-dimer(D-D),INR]were measured before operation(T1),on the first day(T2),on the second day(T3),and on the third day(T4)after operation.The predictive value of perioperative INR for postoperative LEDVT in patients with early cervical cancer was analyzed.Results Since T2,TT,PT,and APTT were shortened,plasma FIB and D-D were increased,and INR was decreased in both groups of patients(P<0.05).There was no statistically significant difference in the dynamic changes in TT,PT,and APTT between two groups at different times(P>0.05).The plasma FIB and D-D of LEDVT group at T2-T4 time point were higher than those of N-LEDVT group,and the INR was lower than that of N-LEDVT group(P<0.05).The receiver operating characteristic(ROC)curve was drawn.The area under the curve(AUC)of perioperative plasma FIB,D-D and INR predicting the risk of postoperative LEDVT in early cervical cancer patients were 0.681,0.671,and 0.816,respectively.Conclusions INR begin to decline from the first day after surgery in patients with early cervical cancer,which can indicate the risk of postoperative LEDVT.
Early cervical cancerModified radical hysterectomyLower extremity deep venous thrombosisInternational normalized ratio of prothrombin time