Plasminogen activator inhibitor-1 gene promoter 4G/5G polymorphism and risks of peripherally inserted central catheter–related venous thrombosis in patients with lung cancer: a prospective cohort study

• Published in: Supportive care in cancer 2021-11, Vol.29 (11), p.6431-6439
• Main Authors: Feng, Yue, Fu, Yan, Xiang, Qiufen, Xie, Lingling, Yu, Chunhua, Li, Junying
• Format: Article
• Language: English
• Subjects: Blood clots; Cancer; Care and treatment; Catheterization; Catheters; Chemotherapy; Cohort analysis; Ethylenediaminetetraacetic acid; Fibrin; Fibrinogen; Genes; Genetic aspects; Genetic polymorphisms; Genetic research; Genotype; Humans; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - genetics; Medicine; Medicine & Public Health; Nursing; Nursing Research; Oncology; Oncology, Experimental; Original Article; Pain Medicine; Plasminogen Activator Inhibitor 1 - genetics; Polymorphism, Genetic; Prospective Studies; Rehabilitation Medicine; Risk assessment; Risk factors; Thromboembolism; Thrombophlebitis; Thrombosis; Ultrasound imaging; Venous Thrombosis - etiology; Venous Thrombosis - genetics
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-021-06207-8

Purpose This study investigated the influence of plasminogen activator inhibitor-1 (PAI-1) gene polymorphisms and other contributing clinical factors on peripherally inserted central catheter–related venous thrombosis (PICC-RVT) in Chinese patients with lung cancer. Methods We conducted a prospective study of 237 participants. Blood samples were collected to detect the PAI-1 4G/5G genotype. Venous thromboembolism risk was calculated by the Caprini risk assessment model. Color Doppler ultrasonography was performed every 7 days for 3 weeks to confirm PICC-RVT. Results The rate of PICC-RVT was 13.50% (32/237). The 5G/5G, 4G/5G, and 4G/4G genotypes were found in 12.50% vs 17.56%, 59.38% vs 49.27%, and 28.12% vs 34.17% in the thrombus group and the non-thrombus group of the participants. No difference was observed in the distribution frequency of the three genotypes between the thrombus and non-thrombus groups. A higher fibrinogen level (OR 1.194, 95% CI 1.004–1.420, P = 0.045) and a higher Caprini score (OR 1.698, 95% CI 1.103–2.614, P = 0.016) were statistically significant risk factors for PICC-RVT. Compared with patients who underwent a pemetrexed/cisplatin regimen, those who were administered paclitaxel/cisplatin (OR 18.332, 95% CI 2.890–116.278, P = 0.002) or gemcitabine/cisplatin (OR 6.617, 95% CI 1.210–36.180, P = 0.029) were at increased risk of PICC-RVT. Conclusion Our finding suggested that there is no statistically significant influence of the PAI-1 4G/5G gene variant on PICC-RVT in Chinese patients with lung cancer. However, patients with higher Caprini scores and higher fibrinogen levels are at increased risk for PICC-RVT, as are patients receiving chemotherapy. Clinical staff should carefully perform a risk assessment for patients with PICC. Those with the above risk factors should pay close attention and take timely and effective preventive measures.