The Identification of Accelerated Coagulability

This report describes a new method for comparing overall clotting characteristics between normal individuals and those with proven malignancy using thrombelastographic (TEG) comparison of native and celite-activated specimens. Native whole blood TEG, celite-activated TEG, and standard coagulation tests were performed on the same blood collection in 90 normals and 90 patients with new malignancies and the results were used to derive a discriminate equation This equation classified correctly all 90 normals and 88 out of 90 cancer patients. The formulation was verified with an additional 82 patients with only one incorrect classification in the 31 cancer subjects. The standard coagulation tests did not discriminate without significant overlap between cancer patients and normals. The high degree of discrimination obtained with our TEG analysis provides a new tool to compare individual clotting differences that may have important clinical applications. However, the results cannot be extrapolated to selectively identify those with malignancy among the general population since many other stimuli may produce accelerated coagulability. This analysis does provide identification of accelerated coagulability in association with new malignancies.