Modified recalcification time (MRT): a sensitive cancer test? Review of the evidence.

In the past, hypercoagulability causing cancer-related thrombosis (Trousseau phenomenon) remained unproven for lack of an appropriate coagulation test. This review proves that a modified recalcification time (MRT) test can detect cancer-related hypercoagulability. The hallmark of this test involves incorporating tissue factor (TF) in accurately assessing coagulability. Blood from controls and cancer patients was incubated with saline and endotoxin (to enhance clotting ability by monocyte-generated TF). The MRT with saline incubation (MRTS) and the MRT with endotoxin incubation (MRTE) were determined instrumentally. The MRTE is a more inclusive measure of total TF activity than the MRTS in nonadvanced cancer. The MRTE values (minutes +/- standard deviation) were: controls-5.69 +/- 0.8; miscellaneous cancers-3.17 +/- 1.1; head, neck, and colon cancers-3.9 +/- 0.6; breast cancers-3.6 +/- 0.6; gynecological cancers-4.1 +/- 0.9; and prostate cancers-3.4 +/- 1.1. The MRTE, by demonstrating hypercoagulability in nonadvanced (including occult) cancer, qualifies as a more sensitive marker for cancer than the Trousseau phenomenon. The data suggest that this test may be the most sensitive blood test to detect early cancer.