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Neutrophil extracel...
Neutrophil extracellular trap formation is an independent risk factor for occult cancer in patients presenting with venous thromboembolism
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- Rosell, Axel (author)
- Karolinska Institutet,Department of Clinical Sciences, Danderyd Hospital, Division of Internal Medicine, Karolinska Institutet, Stockholm, Sweden
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- Gautam, Gargi (author)
- Karolinska Institutet,Department of Clinical Sciences, Danderyd Hospital, Division of Internal Medicine, Karolinska Institutet, Stockholm, Sweden
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- Wannberg, Fredrika (author)
- Department of Clinical Sciences, Danderyd Hospital, Division of Internal Medicine, Karolinska Institutet, Stockholm, Sweden
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- Ng, Henry (author)
- Uppsala universitet,Science for Life Laboratory, SciLifeLab,Institutionen för medicinsk cellbiologi,Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Div Internal Med, Stockholm, Sweden.
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- Gry, Hanna (author)
- Division of Radiology, Danderyd Hospital, Danderyd, Sweden
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- Vingbäck, Emma (author)
- Division of Internal Medicine and Infectious diseases, Danderyd Hospital, Danderyd, Sweden
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- Lundström, Staffan (author)
- Karolinska Institutet,Palliative Care Services and R&D-unit, Stockholms Sjukhem Foundation, Stockholm, Sweden.;Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
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- Mackman, Nigel (author)
- UNC Blood Research Center, Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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- Wallén, Håkan (author)
- Karolinska Institutet,Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Karolinska Institutet, Stockholm, Sweden.
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- Westerlund, Eli (author)
- Karolinska Institutet,Department of Clinical Sciences, Danderyd Hospital, Division of Internal Medicine, Karolinska Institutet, Stockholm, Sweden.
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- Thålin, Charlotte (author)
- Karolinska Institutet,Department of Clinical Sciences, Danderyd Hospital, Division of Internal Medicine, Karolinska Institutet, Stockholm, Sweden.
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(creator_code:org_t)
- Elsevier, 2023
- 2023
- English.
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In: Journal of Thrombosis and Haemostasis. - : Elsevier. - 1538-7933 .- 1538-7836. ; 21:11, s. 3166-3174
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Abstract
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- Background: Venous thromboembolism (VTE), particularly unprovoked VTE, is associated with occult cancer. The optimal screening regimen remains controversial. Neutrophil extracellular traps (NETs) are implicated in cancer-associated thrombosis, and elevated biomarkers of NET formation are associated with poor prognosis.Objectives: To investigate the association between NET formation and occult cancer in patients with VTE.Methods: Blood biomarkers associated with NETs and neutrophil activation (nucleo-somal citrullinated histone H3 [H3Cit-DNA], cell-free DNA, and neutrophil elastase) were quantified in patients with VTE. The primary outcome was cancer diagnosed during a one-year follow-up.Results: This study included 460 patients with VTE, of which 221 (48%) had isolated deep vein thrombosis. Forty-three patients had active cancer at inclusion and were excluded from the primary analysis Cancer during follow-up was diagnosed in 29 of 417 (7.0%) patients. After adjustment for age and unprovoked VTE, the hazard ratio of cancer during follow-up per 500 ng/mL increase of H3Cit-DNA was 1.79 (95% CI, 1.03-3.10). Furthermore, patients with cancer-associated VTE (known active cancer or cancer diagnosed during follow-up) had higher levels of H3Cit-DNA than cancer-free patients with VTE after adjustment for age, hemoglobin, gender, chronic obstructive pulmonary disease, previous cancer, and start of anticoagulant treatment (odds ratio 2.06 per 500 ng/mL increase of H3Cit-DNA [95% CI, 1.35-3.13]).Conclusions: H3Cit-DNA is an independent predictor for occult cancer in patients with VTE and elevated in cancer-associated VTE, suggesting that H3Cit-DNA is potentially a useful diagnostic marker for cancer in patients with VTE and that elevated NET formation is a hallmark of cancer-associated VTE.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- NETs
- neutrophils
- neutrophil activation
- thrombosis
- venous thromboembolism
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Rosell, Axel
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Gautam, Gargi
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Wannberg, Fredri ...
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Ng, Henry
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Gry, Hanna
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Vingbäck, Emma
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Lundström, Staff ...
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Mackman, Nigel
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Wallén, Håkan
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Westerlund, Eli
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Thålin, Charlott ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Journal of Throm ...
- By the university
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Uppsala University
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Karolinska Institutet