Evaluation of the role of serum soluble ST2 as a diagnostic biomarker for cancer-associated venous thromboembolism

Introduction  Venous thromboembolism, a common complication associated with cancer, causes increased morbidity and mortality. D-dimer levels are often increased non-specifically in cancer which limits their use to diagnose venous thromboembolism. The current study aimed to investigate the role of the serum soluble suppression of tumorigenicity 2 (sST2) as a new biomarker to diagnose venous thromboembolism in cancer.

Methods  Eighty-eight patients with different types of cancer were enrolled and divided into two groups: Group I: 44 cancer patients with confirmed diagnosis of venous thromboembolism and Group II: 44 age- and sex-matched cancer patients without any thrombotic complications. The D-dimer test and sST2 measurement were performed for all study subjects.

Results  Serum sST2 levels were significantly higher in Group I than in Group II (p-value < 0.001); the median serum sST2 was 13.02 ng/mL (range: 7.65-117.9 ng/mL) in Group I versus 8.56 ng/mL (range: 5.59-10.33 ng/mL) in Group II. There was a significant positive correlation between serum sST2 and the D-dimer level. Using a receiver operating characteristic curve, sST2 had a greater area under the curve than the D-dimer test (0.974 versus 0.869, respectively). Although the D-dimer test was more sensitive, sST2 had a greater specificity than D-dimer (95.45 % versus 27.3 %, respectively) and a higher positive predictive value (95.3 % versus 56.8 %, respectively).

Conclusion  The results of the current study support a potential role of soluble ST2 to aid in diagnosing venous thromboembolism in cancer patients.

Keywords
Venous thromboembolism; Cancer; ST2; D-dimer