Markers of activation of coagulation in cancer patients

Abstract

BACKGROUND: Prothrombotic tendency is characteristic of tumors. The aim of the study is to investigate the changes in the laboratory parameters for coagulation and fi brinolysis, namely in fi brinogen, thrombinantithrombin complex (ТАТ), tissue factor (ТF), prothrombin fragment (F1+2), antithrombin III (AT III), D-dimer and screening coagulation tests in cancer patients before initiation of chemotherapy. MATERIALS AND METHODS: Levels of F1+2, fi brinogen, ТАТ, AT III, TF, D-dimer, PT, aPTT and TT were measured baseline in 80 patients with breast and lung cancer before systemic treatment. The same parameters were investigated in 65 healthy volunteers. TF, ТАТ, F1+2 were measured by ELISA; AT III, D-dimer, fi brinogen and screening coagulation tests were measured by automated coagulation system Sysmex CS 2000i. RESULTS: Levels of F1+2, fi brinogen, ТАТ, TF, and D-dimer in cancer patients were signifi cantly higher than those in the control group, while the levels of ATIII activity were signifi cantly lower (p < 0.001). The highest area under the ROC curve was for D-dimer, which made it a good marker for the risk of thrombosis. CONCLUSION: Higher levels of TF, ТАТ, F1+2, fi brinogen and D-dimer and lower activity of АТ III in cancer patients support our hypothesis of an association between malignant disease and coagulation disorders. Cancer patients are at an increased risk of thrombosis wherefore antithrombotic prophylaxis may be considered (Tab. 6, Fig. 2, Ref. 34).

The clinical significance of TAT, PIC, TM, and t-PAIC in vascular events of BCR/ABL-negative myeloproliferative neoplasms

“…Among them, patients with higher TAT, TM and t-PAIC were more likely to experience thrombotic events, and only TAT was positively correlated with thrombotic events (Spearman r = 0.287, P = 0.019). Our data showed that the activity of ATIII is significantly lower in MPN patients with thrombosis, which can be explained by pathologically increased thrombin formation and increased consumption for the formation of TAT complexes [ 47 ]. In spite of the recognized risk of thrombosis, patients with MPN show little or no abnormalities of traditional coagulation tests such as PT and APTT, perhaps because these are unable to represent the balance between pro- and anti- coagulants nor the effect of platelets and blood cells [ 32 ].…”