Significance of coagulation and fibrinolysis markers for benign and malignant soft tissue tumors

Abstract

Background The intimate relationship between coagulation and fibrinolysis in malignant tumors is a well-known phenomena, with the malignant phenotype enhancing coagulation and fibrinolysis. We hypothesized that soft tissue sarcoma (STS) affects the expression of coagulation and fibrinolysis markers, which could be used to distinguish STS from benign soft tissue tumors. We analyzed the correlations between plasma levels of D-dimer (DD), plasmin-α2 plasmin inhibitor complex (PIC), soluble fibrin (SF), and thrombin-antithrombin III complex (TAT) in benign soft tissue tumors and STS to elucidate whether these markers can be used to predict STS. Methods Plasma DD, PIC, SF and TAT levels in primary soft tissue tumors (benign 67, STS 68) were measured before biopsy or treatment. The marker levels were analyzed and compared to various clinicopathological parameters. Results In malignancy (STS), the average DD, PIC and SF levels were significantly higher than in benign tumors. Multivariate logistic analysis of continuous variables indicated that only PIC exhibited a significant difference (OR: 24.5, 95%CI: 3.55–170, p = 0.0012). Receiver operating characteristic curve analysis produced area under the curve values for DD: 0.691, PIC: 0.784, SF: 0.734 and TAT: 0.588. Youden’s index was used to establish thresholds of 0.37 (DD), 0.80 (PIC), 0.90 (SF) and 0.82 (TAT). Threshold values for PIC and SF indicated high specificity (0.881, 0.791) and high positive predictive value (0.818, 0.745), respectively. The highest accuracy value among the markers was observed for PIC (0.704). Significant differences in multivariate analysis of binary variables were demonstrated by categorizing low and high groups based on their threshold, PIC (≥0.80) (OR: 3.36, 95%CI: 1.19–9.43, p = 0.0212) and SF (≥0.90) (OR: 2.63, 95%CI: 1.04–6.66, p = 0.0404) . Conclusions Of the coagulation and fibrinolysis markers studied, increased PIC levels were related to STS and over 0.80 PIC was the most suitable for the prediction of STS, which, along with other diagnostic tools, represents a helpful subsidiary tool for the prediction of STS.

Identification of TAT, PIC, tPAIC, and TM complex as biomarkers for prognosis and early evaluation of non-severe pneumonia and severe pneumonia diagnosis

“…In this study,we observed signi cantly elevated sTM,TAT,PIC and t-PAI•C expressions in severe pneumonia groups compared with healthy and non-severe pneumonia. sTM, a transmem -brane glycoprotein, is abundant on all endothelial surfaces [14].TAT directly re ects the activation of the coagulation system and can be used as a marker of coagulation initiation [15]. The half-life of activated plasmin is very short; and plasmin reacts rapidly with brinolytic system α2 plasmin inhibitor to combine 1:1 and thereby form PIC, which then re ects the early rise in plasmin and measurement of which can be used to evaluate the degree of brinolytic activation in vivo [16].…”

Differentiating benign and malignant neoplasms: A possible new role for coagulation and fibrinolysis indicators

“…Some studies have attempted to use coagulation and brinolysis markers in the differential diagnosis of more than 9 soft tissue sarcomas and more than 7 benign tumors without regard to stage or type [48] . We have shown that coagulation and brinolytic functions are universally activated in various malignant tumors, which is completely different from benign tumors.We further tried to use coagulation and brinolysis markers in the differential diagnosis of benign and malignant tumors.…”

Effects of coagulation function indicators and tumor markers on diagnosis and clinicopathological characteristics of endometrial cancer

“…D2 consists of two cross-linked D fragments of fibrin, which is the product of fibrin degradation. 21 Recently, elevated D2 levels have been identified to be favorable in the diagnosis and prognosis of many malignancies; for example, lung, 22,23 pancreatic, 24 breast, 25 ovarian, 26 endometrial. [27][28][29] FIB serves as a precursor of fibrin, and during the final stages of clotting, soluble fibrinogen converts into insoluble fibrin, leading to blood clot formation.…”