Coagulation-fibrinolysis system and markers of collagen metabolism in lung cancer

Abstract

Background. Evidence suggests that the fibrinolysis system and peritumoral connective tissue play important roles in tumor spread. Methods. In this study, the authors evaluated the following parameters in 30 consecutive patients with lung cancer: thrombin‐antithrombin complex (TAT), cross‐linked fibrin split products D‐dimer (DD), plasmin‐alpha2‐antiplasmin inhibitor complex (PAP), and two antigens related to connective tissue, the aminoterminal propeptide of type III procollagen (PIIIP) and the 7s domain of type IV collagen (7s‐collagen). Results. Each parameter was increased significantly in the patients with cancer compared with the control subjects. Except for PIIIP, their concentration in blood was elevated to Significantly greater extent in the patients with distant metastases. The PAP concentration correlated well with the plasma concentration of TAT (r = 0.5; P < 0.01) and DD (r = 0.9; P < 0.0001). There was also strong correlation between the serum concentrations of PIIIP and 7s‐collagen (r = 0.7; P < 0.001). In patients with localized disease, DD levels were correlated significantly with those of PIIIP (Spearman rank‐order correlation [ra] = 0.6; P < 0.025) and 7s‐collagen (ra = 0.6; P < 0.01). In the group with disseminated metastases, there was significant inverse relationship between serum PAP concentrations and serum concentrations of 7s‐collagen (ra = −0.6; P < 0.025). Conclusions. These results confirm the presence of subclinical chronic activation of the parameters of intravascular clotting‐fibrinolysis and alterations in the extracellular matrix of patients with lung cancer. These parameters may be useful as indicators of the clinical progression of malignant disease, particularly of lung cancer.

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).…”

“…Both Pectasides and Canobbio (Canobbio et al, 1986;Pectasides et al, 1999) show shortening of functional clotting assay times equivalent to our 3-month findings. In lung cancer patients receiving chemotherapy, Gabazza et al (1992) reports an early shortening of APTT (at days 2, 5 and 7 following treatment) and a slightly later shortening of PT (at days 5, 7 and 14 following treatment). The fact worthy of note in the current study is that the shortening of APTT is more pronounced in the group subsequently developing VTE.…”

Correlation between tumor necrosis factor-alpha and d-dimer levels in non-small cell lung cancer patients

“…The elevated levels of D-dimer may, in fact, indicate a host compensatory response to the increased formation of cross-linked fibrin [5,11], as indicated by the finding of a concomitant activation of the coagulation pathway in NSCLC [2][3][4][5][6]. Indeed, in a recent study we have shown that D-dimer levels are increased in NSCLC concomitantly to thrombin/anti-thrombin III complexes (TATc), an activation marker of coagulation [5].…”

Increased circulating levels of thrombin‐activatable fibrinolysis inhibitor in lung cancer patients

“…Several studies have demonstrated the tendency of clotting and fibrinolytic disorders to develop in patients with malignancy [1,2] The clinical presentation of thrombotic alterations in cancer patients may vary from the classic picture of consumptive coagulopathy or thromboembolism to low-grade intravascular coagulation [3,4]. Specific conditions associated with cancer, such as stasis due to prolonged immobilization, surgery, infections, vascular endothelium injury due to chemotherapeutic agents, and abnormalities of the blood coagulation system, contribute to the hypercoagulable and thrombophilic state of patients with cancer [5,6].…”