THROMBIN TIME

What is this test?

Thrombin time (abbreviated as TCT & TT) is one of many tests that review if your blood is clotting ordinarily. Blood clotting or coagulation is required to help arrest bleeding when one has an injury.

Proteins in the blood are termed clotting factors that help special blood cells stop bleeding. Thrombin is an enzyme in the liquid component of the blood or plasma. It aids a clotting factor described fibrinogen change into fibrin to form clots. Thrombin time is a stratagem of how long the blood’s plasma takes to make a clot. This test determines how long it takes fibrinogen to convert into fibrin. Difficulties with fibrinogen turning into fibrin can prevent blood from clotting ordinarily and cause extreme bleeding. The test may be done to help diagnose difficulties such as:

  • Inherited diseases leading to low fibrinogen or fibrinogen ailments
  • Liver diseases like liver cancer, cirrhosis, and hepatitis
  • Cancers such as kidney cancer commonly called renal carcinoma or multiple myeloma
  • Some other health conditions, including ulcerative colitis and lupus
  • Antibodies against fibrinogen one’s body made if one had surgery that employs fibrin glue from cow sources
  • Propagated intravascular coagulation, a situation in which your body utilises more fibrinogen

Some medications can also lead to a more prolonged thrombin time. This includes the blood-thinning medications:

  • Heparin
  • Argatroban
  • Bivalirudin
  • Warfarin

Why do I need this test?

One may require this test if your blood does not appear to be clotting usually.

Symptoms can include:

  • Extravagant bleeding or bruising
  • Pregnancy predicaments, such as repeated miscarriages early in pregnancy, and unusual bleeding following delivery

What other tests might I have along with this test?

One may need other tests to regulate your blood’s clotting ability. These may include:

  • Reptilase time. Alike thrombin time, this test estimates how long it needs for fibrinogen to convert into fibrin. It determines if a long thrombin term is because of heparin.
  • Prothrombin time. This test provides information about fibrinogen and other blood parts that aid to form clots. It’s also used to estimate the effects of warfarin.
  • Activated partial thromboplastin time. This test also supplies information about factors in blood clotting. And it’s done to measure the results of heparin.

What do my test results mean?

Several things may affect your lab test results. These involve the method each lab practices to do the test. Even if the test results are various from the usual value, they may not have a problem. To acknowledge what the results mean for you, discuss with your healthcare provider. 

 An ordinary thrombin time is about 14 to 19 seconds.

A more prolonged thrombin time can mean low fibrinogen, raised fibrinogen, or fibrinogen that’s not working usually. It can also be because of drugs that affect blood clottings, like heparin or argatroban.

A prolonged thrombin time can result from proteins in the blood from multiple myeloma or amyloidosis. Or it could be done by antibodies to cow thrombin, which is used as a component of the testing.

How is this test done?

The test is performed with a blood sample. A needle is employed to draw blood from a vein in your hand or arm. The sample is kept in a tube containing a chemical that prevents it from clotting.

Does this test pose any risks?

Undergoing a blood test with a needle poses some risks. These include infection, bleeding, bruising, and feeling dizzy. When the needle pricks in the arm or hand, one may feel a petty sting or pain. Eventually, the site may be sore.

What might affect my test results?

Some medications that alter blood clotting will change your test results, like heparin and warfarin.

How do I get ready for this test?

Acknowledge your healthcare provider if you’re getting any medicines, particularly those that affect your blood’s capacity to clot. Be certain that your healthcare provider is aware of all medicines, herbs, vitamins, and supplements you are using. This includes drugs that don’t require a prescription and even some illegal drugs in use.

Clinical Information

 Extended clotting times may be connected with a wide variety of coagulation anomalies including:

  • Lack or functional deformity (congenital or acquired) of several of the coagulation proteins

       – Lack of functional deformity of platelets

       – Precise factor inhibitors

       – Acute propagated intravascular coagulation

       – Exogenous anticoagulants for eg, heparin, warfarin

The prothrombin time and activated incomplete thromboplastin time are first-order tests for coagulation anomalies and are increased in many disorders. A battery of coagulation tests is usually required to ascertain the cause of lengthened clotting times.

Thrombin catalyzes the conversion of fibrinogen to fibrin, through cleaving fibrinopeptides A and B, which is accompanied by polymerization of fibrin to form a clot. The thrombin time (TT) test estimates the time of clot formation when thrombin is appended to citrated plasma. The phospholipid-dependent procoagulant enzyme cascades including intrinsic, extrinsic, and “common” pathways, are neglected by the increase of exogenous thrombin. Accordingly, the TT mainly reflects functions and communications of solution-phase exogenous thrombin and endogenous fibrinogen.

Significance of Preoperative Thrombin Time in Patients with ESCC

Squamous cell carcinoma of the esophagus (ESCC) is the most frequent kind of esophageal cancer and one of the most common cancers worldwide. Additionally, it is China’s fourth leading cause of cancer-related death. Despite the availability of sophisticated diagnostic tools, surgical procedures, and therapy for ESCC patients, the 5-year survival rate remains poor. In order to guide tailored treatment, a more efficient biomarker to recognize the biological characteristics of ESCC patients must be found.

The link between cancer and thrombosis is well established, and practically all kinds of cancer are linked to coagulation activation, even when no thrombosis is present. Cancer patients are four to six times more likely to develop venous thromboembolism (VTE). Cancer-induced hemostatic activity has also been found to increase tumor development and dissemination, as well as the inflammatory cell response, tumor angiogenesis, and metastasis. Abnormal coagulation parameters, which represent active coagulation and fibrinolytic systems, have been linked to tumor growth and reduced overall survival (OS). Increases in the prothrombin time (PT) and international normalized ratio (INR) have been linked to lower survival in lung cancer patients, according to some studies. Furthermore, high levels of circulating biomarkers including fibrinogen, fibrin(ogen) split products, and D-dimer have been linked to a lower overall survival (OS) in breast cancer, colorectal cancer, and melanoma. In pancreatic cancer and gallbladder cancer, high D-dimer levels and hyperfibrinogenemia have also been established as independent prognostic indicators. Although the thrombin time (TT) is one of the most often used coagulation assays in laboratories, its predictive usefulness in cancer has received little attention. Furthermore, because few researchers have looked into the link between ESCC and coagulation disorders in-depth, the TT’s predictive usefulness is unknown.