Alteration of Antithrombin III and D-dimer Levels in Clinically Localized Prostate Cancer

Abstract

Purpose:We performed a comparative analysis of the plasma levels of antithrombin (AT) III, plasminogen, fibrinogen, and D-dimer among patients with and without clinically localized prostate cancer to investigate the clinical significance of the coagulation profile in prostate cancer. Materials and Methods: A prospective study was performed in which plasma levels of AT III, plasminogen, fibrinogen, and D-dimer were assessed in patients before they underwent prostate biopsy. According to the results of the biopsy, the patients were categorized into the cancer group or the control group. Levels of the four coagulation factors were then compared between the cancer and control groups. Also, levels of the four coagulation factors were correlated with tumor stage and grade in the cancer group. Results: The cancer group had significantly lower levels of AT III activity and higher plasma D-dimer levels than did the control group (p=0.007 and p=0.018, respectively). Within the cancer group, no significant differences were observed in the levels of AT III, plasminogen, fibrinogen, or D-dimer between those with a pathological Gleason score of ≥7 and otherwise. Regarding pathologic stage of prostate cancer, the subjects with organ-confined disease and those with extraprostatic extension of a tumor demonstrated no significant differences in the preoperative levels of the four coagulation factors analyzed. Conclusions: Our results suggest that plasma levels of AT III and D-dimer are altered in patients with prostate cancer. Further study is needed to elucidate the underlying mechanism and clinical significances of such a phenomenon among patients with clinically localized prostate cancer.

Inflammation: an important parameter in the search of prostate cancer biomarkers

“…They found that this protein was widely expressed in PCa, but was gradually lost in tumors with high Gleason grade [32]. A decrease in plasma levels of Antithrombin-III is also reported in patients with colon and ovarian cancer, especially in presence of metastasis [33], other than in PCa [34]. In our study, we found a significantly lower expression of Antithrombin-III in PCa than the BPH.…”

Prognostic and predictive value of plasma D-dimer in advanced non-small cell lung cancer patients undergoing first-line chemotherapy

“…Fibrin matrices promote the migration of a substantial number of cancer cells and neovascularization, and are essential for tumor angiogenesis, growth, and metastasis [8][9][10][11]. Accumulated clinical data showed that enhanced activation of coagulation and fibrinolysis, as reflected by high levels of D-dimer, was significantly associated with an unfavorable prognosis in patients with cancer [13][14][15][16][17][18][19][20][21][22][23][24][25][26]. It was reported that D-dimer levels were significantly associated with clinical stage, lymphovascular invasion and axillary lymph node involvement in operable breast cancer patients, and D-dimer was suggested to be a biomarker for predicting early tumor metastases [14].…”

“…It elevated levels have been found in patients with various malignant tumors, including breast, gastriocolorectal, cervical, prostate, esophagus and lung cancer [13][14][15][16][17][18][19][20][21][22][23][24][25][26]. In this report, we conducted a prospective study to determine the clinical significance of plasma D-dimer in patients with advanced NSCLC who undergoing first-line chemotherapy.…”

Platelets, Coagulation and Cancer: Multifaceted Interactions

“…Furthermore, others have advocated the use of low AT and raised D-Dimer as prognostic markers for gynecological malignancy (Koh et al, 2001;. As one would have expected, elevated Thrombin Antithrombin Complex (TAT) observed in malignancy correlated with its severity and was often associated with abnormalities in the Thrombin Activatable Fibrinolysis Inhibitor (TAFI) (Hong et al, 2010;Kaftan et al, 2011). Further studies are deemed necessary to clarify the possible relation between AT level and cancer.…”