Fibrinolytic Activity in Malignancy

Abstract

Euglobulin lysis time (ELT), euglobulin fibrinolytic activity on fibrin plate (EFA), plasminogen, tissue-type plasminogen activator (t-PA) activity and antigen, ;2-antiplasmin (α2-AP), plasminogen activator inhibitor (PAI) and fibrinogen degradation products (FDP) were determined in a group of 149 patients (mean age 57 ± 13 years, 93 male), with different malignancies (digestive 61, lung 18, urological 24, ginaecological 16, others 30). Findings were compared with those of 44 age-sex matched healthy subjects. There was a significant prolongation of ELT (p <0.003), a decrease of plasminogen (p < 0.004) and an increase of PAI (p < 0.0001) in patients as compared to controls, being similar EFA, t-PA, α2AP and FDP. No differences in any ot these parameters were found in patients with metastatic disease (n= 65) as compared with those with local disease (n= 84). As regards to tumour localization, plasminogen and t-PA decrease were more pronounced in lung malignancies and PAI increase in lung and digestive malignancies. We conclude that there is an impairment in blood fibrinolytic activity in malignancy. Reduced fibrinolysis seems to be related to localization but not to degree of tumoral activity. That might have clinical complications.

Pathways of Coagulation/Fibrinolysis Activation in Malignancy

“…67 When the circulating fibrinolytic system is studied in its totality (that is, both activators and inhibitors together) overall activity appears to be more often decreased due to an excess of inhibitors rather than increased. 68,69 Such inhi bition may be attributed not only to inhibitors of plasmin but also to PAIs. 49,70 The development of IHC techniques together with the availability of many high-quality antibodies to com ponents of coagulation reactions has provided solutions to many of these problems.…”