Clinical and prognostic significance of coagulation assays in lung cancer

Abstract

Activation of coagulation and fibrinolysis is frequently encountered among cancer patients. Such tumors are supposed to be associated with higher risk of invasion, metastases and eventually worse outcome. The aim of this study is to explore the prognostic value of blood coagulation tests for lung cancer patients. The study comprised 110 lung cancer patients. Pretreatment blood coagulation tests including PT, aPTT, PTA, INR, D-dimer, fibrinogen levels and platelet counts were evaluated. The plasma level of all coagulation tests revealed statistically significant difference between patient and control group (p < 0.001). There was a significant association between D-Dimer levels and histological subtypes of NSCLC, pointing an elevated plasma D-dimer level in squamous cell cancer (p = 0.035). Patients with extensive stage SCLC exhibited evidently higher levels of D-Dimer, INR and PLT (p = 0.037, p = 0.042, p = 0.04, respectively). Prolongation of PT and INR had statistically significant adverse effect on survival (p = 0.05 and p = 0.014, respectively). Although prolonged aPTT and high levels of D-dimer was associated with worse survival, the difference was not statistically significant (p = 0.117, p = 0.104). Multivariate analysis revealed INR as the sole independent prognostic variable among coagulation parameters (p = 0.05). In conclusion, elevation of PT and INR are associated with decreased survival in lung cancer patients.

Association of ABO blood groups with von Willebrand factor, factor VIII and ADAMTS-13 in patients with lung cancer

“…Additionally, significant differences in the plasma levels of LDH, CEA, D-dimer, VWF and ADAMTS-13, and FVIII activity were observed between patients with and without distant metastasis. These results are in agreement with those of previous studies, which demonstrated an increased tendency for the development of coagulative and fibrinolytic disorders in patients with metastatic diseases (3,21). Furthermore, these results are similar to the observations of Oleksowicz et al (22), who identified increased VWF levels and ADAMTS-13 deficiencies in patients with metastatic tumors.…”

“…Significant increases in the blood concentrations of thrombin-antithrombin III complexes, fibrinogen and D-dimer have been reported in patients with lung cancer exhibiting extensive or limited disease. The extent of such activation of these markers has also been associated with tumor stage and prognosis (2,3). However, the origin of the activation of the coagulative-fibrinolytic system in lung cancer remains incompletely understood.…”

Clinical significance of plasma fibrinogen and D-dimer in predicting the chemotherapy efficacy and prognosis for small cell lung cancer patients

“…Additionally, a growing body of evidence suggests the existence of a correlation between activation of coagulation and fibrinolysis and tumor angiogenesis, invasion, progression, and metastatic spread [9][10][11][12][13][14][15][16]. In clinical studies, many researchers have documented the relationship between hemostatic abnormalities and several malignancies, and various hemostasis markers associated with tumor staging and prognosis have previously been reported [17][18][19][20][21][22][23][24][25][26][27][28][29][30]. In lung cancer, plasma fibrinogen and D-dimer levels are associated with tumor pathological stage, response to therapy, and survival [26][27][28][29][30].…”

“…In clinical studies, many researchers have documented the relationship between hemostatic abnormalities and several malignancies, and various hemostasis markers associated with tumor staging and prognosis have previously been reported [17][18][19][20][21][22][23][24][25][26][27][28][29][30]. In lung cancer, plasma fibrinogen and D-dimer levels are associated with tumor pathological stage, response to therapy, and survival [26][27][28][29][30]. However, only a few patients with SCLC were included in these studies [28][29][30].…”

“…In lung cancer, plasma fibrinogen and D-dimer levels are associated with tumor pathological stage, response to therapy, and survival [26][27][28][29][30]. However, only a few patients with SCLC were included in these studies [28][29][30]. To date the use of plasma fibrinogen and D-dimer determinations in the prediction of response to chemotherapy and prognosis has not been evaluated in patients with SCLC.…”