Prognostic impact of an activation of coagulation in lung cancer

Abstract

The activation markers (means +/- SEM) were lower in the 33 responders (RSP; complete or partial remission) than in the 66 non-responders (NRSP): TAT 3.96 +/- 0.48 vs. 9.69 +/- 1.57 micrograms/l (P < 0.001), and F1 + 2 1.09 +/- 0.09 vs. 1.64 +/- 0.25 nmol/l (P < 0.05). TAT levels were > 6 micrograms/l in 30 of 66 (45%) NRSP, but only 4 of 33 (12%) RSP. 88% of patients with TAT < or = 6 micrograms/l achieved remission, and 45% with TAT > 6 micrograms/l (P = 0.0014). In the subgroup of 46 patients with advanced disease, the six RSP showed lower TAT than the 40 NRSP: 4.65 +/- 0.94 vs. 11.92 +/- 2.49 micrograms/l (P < 0.01); one of six (17%) RSP, but 21 of 40 (53%) NRSP showed TAT > 6 micrograms/l. These data suggest that in lung cancer the activation of coagulation is an independent prognostic factor, since TAT levels were different between RSP and NRSP, also within the homogeneously unfavourable metastatic subgroup. It should be further studied, whether TAT can identify patients, whose prognosis could be improved by anticoagulation as an adjunct to standard antineoplastic therapy.

Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer

“…The elevated prechemotherapy TAT levels in advanced breast cancer patients in this study support previous findings in breast (Falanga et al, 1998;Donati and Falanga, 2001), lung (Gabazza et al, 1992;Seitz et al, 1997) and colorectal cancer (Iversen et al, 1996;Iversen and Thorlacius-Ussing, 2002).…”

Inducible expression of tissue factor in small-cell lung cancer: impact on morphology and matrix metalloproteinase secretion

“…Clinical studies revealed that increased markers of coagulation activation correlate with disease progression and unfavourable prognosis irrespective of the histological type of lung cancer (Chew et al 2008;Seitz et al 1997). The present studies aimed at investigating the role of TF in the reversible adaptation of the SCLC cell phenotype, which may be instrumental in metastasis.…”

The Thrombophilic State in Cancer Patients

“…Furthermore, they are less susceptible to in vitro artifacts [50]. Several studies have shown that most of the cancer patients, regardless of the presence or absence of clinical evidence for thromboembolic disease, have elevated levels of F1 + 2, TAT and D-dimers before the initiation of treatment [51, 52, 53, 54, 55, 56, 57]. A recent study on markers of activated hemostasis and fibrinolysis in pulmonary malignancies has shown a direct contribution of the tumor to the activation of coagulation and fibrinolysis with significantly higher levels of FPA, F1 + 2, TAT and D-dimers in the pulmonary venous blood than in blood simultaneously drawn from the superior vena cava [58].…”