Global Fibrinolytic Capacity Increased Exponentially in Metastatic Colorectal Cancer

Kockar, Cem; Koçkar, Olga; Öztürk, Mustafa; Dağlı, Mehmet; Bavbek, Nüket; Koşar, Ali

doi:10.1177/107602960501100214

Cited by 14 publications

(10 citation statements)

References 23 publications

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“…The current authors thus speculate that the tumoural mesothelium was unable to react adequately to talc stimulation. Also, the DD profile in most of those failed cases showed an increased fibrinolytic activity, which is in relation with the well known pro-fibrinolytic expression of many tumours in advanced stages [11,12].…”

Section: Discussionsupporting

confidence: 58%

The neutrophilic and fibrinolytic response to talc can predict the outcome of pleurodesis

Psathakis

Calderón-Osuna²,

Romero-Romero³

et al. 2006

European Respiratory Journal

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It was hypothesised that monitoring neutrophil and D-dimer (DD) levels into the pleural fluid, after talc instillation, could predict the outcome of pleurodesis.The current authors investigated a total of 168 patients with malignant pleural effusion, who were treated with talc poudrage. According to the outcome the patients were categorised into one of two groups, either successful or failed pleurodesis. In all cases, pleural fluid neutrophils and DDS were determined on serial measurements at 0, 3, 24 and 48 h after the procedure. The time course of these parameters was assessed in both groups and the time point at which they could better predict the outcome was further explored.Neutrophils rose rapidly after talc poudrage in both groups, reaching a plateau at 24 h, although in successful pleurodesis this response was significantly higher. DD dropped markedly at 24 h in the group with the successful outcome, but it did not show significant changes in the other group. A cut-off value of 61% for neutrophils and 61 mg?L -1 for the DD at 24 h yielded the best prognosis for successful pleurodesis. The current authors conclude that serial measurements of neutrophil and D-dimer values into the pleural fluid after talc poudrage could be used as predictors of the outcome of pleurodesis.

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Section: Discussionsupporting

confidence: 58%

The neutrophilic and fibrinolytic response to talc can predict the outcome of pleurodesis

Psathakis

Calderón-Osuna²,

Romero-Romero³

et al. 2006

European Respiratory Journal

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“…In a rough description if the relevant underlying mechanisms, it is believe that thrombocytosis is induced through a paraneoplastictype over-expression of thrombopoietin (TPO) and through the local and systematic release of cytokines, such as IL-1, IL-3, IL-6, IL-11 and other proteins like granulocyte macrophage colonystimulating factor (GM-CSF), FMS-like tyrosine kinase 3 (FLT3) ligand and fibroblast growth factor (FGF), which induce the production of platelets [38][39][40]. Moreover, the peripheral consumption of platelets during the formation of micro-emboli in the framework of a chronic, compensated subclinical disseminated intravascular coagulation, which accompanies the natural course of colorectal cancer, is a strong stimulus for the production of new platelets in order to maintain the platelet count within the normal range [41,42].…”

Section: Colorectal Cancer-induced Hypercoagulationmentioning

confidence: 99%

Hypercoagulation in colorectal cancer: What can platelet indices tell us?

2014

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Colorectal cancer, as all solid malignancies, is accompanied by changes in the haemostatic mechanism favoring the establishment of a thrombotic potential, with platelets playing a key-role in this framework; they further link colorectal cancer progression and hypercoagulation with the immune-response against the neoplastic spread. Under this rationale, various studies have assessed the use of platelet indices as prognostic markers of the biological behavior of colorectal cancer, demonstrating significant results. We herein attempt to summarize in a narrative and critical approach the relevant available data and the underlying pathophysiology, stressing the necessity of a more thorough understanding and future implementation of platelet indices in all stages of care we deliver to colorectal cancer patients.

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“…Ganesh [88] High uPAR levels associated with decreased OS; independent of age, stage, tumor grade. Kockar [89] Heightened fibrinolysis (elevated D-dimer, global fibrinolytic activity) in metastatic vs. local disease.…”

Section: Clinical Observations Of the Fibrinolytic System In Cancermentioning

confidence: 99%

The Plasminogen Activator System and Cancer

McMahon

Kwaan²

2007

Pathophysiol Haemos Thromb

136

105

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The fibrinolytic system, more appropriately referred to as the plasminogen activator system, controls not only the intravascular fibrin deposition but also participates in a wide variety of physiologic and pathologic processes. In cancer, the components of this system are involved in tumor growth, invasion and metastasis, through their effect on angiogenesis and cell migration. These components are found in most tumors and their expression signifies not only their function but also carries a prognostic value. Their expression is in turn modulated by cytokines and growth factors, many of which are up-regulated in cancer. Though both plasminogen activators, tPA and uPA, are expressed in tumor cells, uPA with its receptor (uPAR) is mostly involved in cellular functions, while tPA with its receptor annexin II on endothelial surface regulates intravascular fibrin deposition. Among the inhibitors of fibrinolysis, PAI-1 is a major player in the pathogenesis of many vascular diseases as well as in cancer. Therapeutic intervention, either using plasminogen activators or use of experimental inhibitor agents against PAI-1, has shown encouraging results in experimental tumors but not verified clinically. Information provided in this brief review is aimed to promote greater interest in the role of the plasminogen activator system in cancer.

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Global Fibrinolytic Capacity Increased Exponentially in Metastatic Colorectal Cancer

Cited by 14 publications

References 23 publications

The neutrophilic and fibrinolytic response to talc can predict the outcome of pleurodesis

The neutrophilic and fibrinolytic response to talc can predict the outcome of pleurodesis

Hypercoagulation in colorectal cancer: What can platelet indices tell us?

The Plasminogen Activator System and Cancer

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