Abstract
<title>Abstract</title> <p>Background: Venous thromboembolism (VTE) is a common and potentially fatal perioperative complication in patients with gynecological malignancies. Emerging evidence links gut microbiota metabolite trimethylamine N-oxide (TMAO) with thrombosis, but their roles in cancer-related VTE remain unclear. Methods: A nested case-control study was conducted among 981 patients who underwent gynecologic cancer surgery.Fifty-one VTE cases confirmed by vascular ultrasound or CTPA were matched 1:1 with controls by surgical method and age (± 5 years). Plasma TMAO concentrations were measured using ELISA. Results: Plasma TMAO levels varied widely (15-fold range), and the median level was slightly higher in the VTE group (5.32 [3.73–10.87] µmol/L) than controls (4.95 [3.32–11.55] µmol/L), though the difference was not statistically significant (P = 0.83). Conclusion: There was no correlation between the formation of VTE and TMAO levels in patients with gynecological malignant tumors during perioperative period.Although we found that plasma TMAO levels were higher in the VTE group, the lack of statistical significance may be due to the limited sample size. Larger, multicenter studies are needed to explore the role of gut microbiota and TMAO metabolism in tumor-associated thrombosis.</p>