Plasma Thrombin-Antithrombin Complexes, Latent Coagulation Disorders and Metastatic Spread in Lung Cancer: A Longitudinal Study

Abstract

In patients affected with different tumours, disorders concerning clotting are frequently observed. The biological processes leading to coagulation are probably involved in the mechanisms of metastasis. We studied plasma levels of thrombin-antithrombin III complexes (TAT) in 90 patients affected with lung tumours subgrouped in small cell and non-small cell (NSC) lung cancer: 17 patients had no evidence of disease after surgery (NE); the remaining 73 patients were divided according to the absence (LOC) or the presence (META) of metastases. All the patients were followed up for several months. In all the lung cancer patient groups, at the beginning of the study we detected TAT levels that were higher than in controls. During the follow-up period, the NSC-NE patients with no recurrence of the disease as well as the NSC-LOC patients responding to the treatment had a decrease in TAT levels (p < 0.01 and p < 0.05, respectively). The NSC-META patients with progression of their disease had, in contrast, an increase in TAT levels (p < 0.01). Our data reveal the presence of ‘latent coagulation disorders’ as assessed by the presence of high TAT levels in the majority of lung cancer patients. The follow-up study indicates that in the NSC group, a relation exists between coagulation activation and rate of tumour progression and/or response to treatment. In cancer patients the early detection of coagulation disorders could also allow, therefore, the prevention of thromboembolism and/or haemorrhage by administration of appropriate treatment.

Relationship of Coagulation Test Abnormalities to Tumour Burden and Postoperative DVT in Resected Colorectal Cancer

“…The presence of advanced cancer triggered the haemostatic system to a much greater extent than expected after that kind of surgery, and the coagulation activation was further augmented 3 months after the palliative operation. In accordance with the present data, a study on non-small-cell lung cancer has demonstrated decreasing TAT values in patients responsive to therapy and increasing values in those with disease progression (29).…”

Expression of high‐abundance proteins in sera of patients with endometrial and cervical cancers: Analysis using 2‐DE with silver staining and lectin detection methods

“…Differential levels of serum ATR in patients with EACa, SCCa and ACCa have not been previously reported although the increased levels of ATRthrombin complex have been demonstrated in the plasma of lung cancer patients [26] as well as patients with the various gynecological cancers [27]. Among the latter, the highest levels of ATR-thrombin complex were detected in patients with ovarian carcinoma, followed by cervical cancer patients and endometrial cancer patients, respectively [27].…”

The Role of the Plasminogen Activation System in Cancer

“…A prolonged prothrombin time, 304 as well as increased levels of individual clotting factors including factors V, VIII, IX, and XI are often observed. Other useful markers that are indicative for ongoing activation of the coagulation cascade in cancer patients in vivo include protease-inhibitor complexes such as thrombin-antithrombin III (TAT) complexes 307 and circulating endothelium activation products such as thrombomodulin (TM). 308 Plasma levels of uPA were increased in some patients with endometrial and cervical cancer, 309,310 in pancreatic and colorectal carcinomas, 311 cancer of the prostate 312 and liver.…”