Pre- and postsurgery activation of blood coagulation in gastric and large bowel cancers: diagnostic, therapeutic and prognostic hints.
In 12 patients with gastric cancer and in 14 with large bowel neoplasia, classified according to the TNM system, some major blood indices of hemostasis, platelet activation and fibrinolysis were assessed before and for 1 month after surgery, to show whether possible variations of such indices may provide useful clues to follow-up, treatment effectiveness and prognosis. The following conclusions may be drawn: (1) the assay of platelets, fibrinogen, AT III, fibrin(ogen) degradation products, fragment X, platelet factor 4 has provided useful clues in neither group of patients; (2) preoperative high beta-thromboglobulin (beta-TG) is a reliable index of tumor presence in both gastric and large bowel cancer; (3) postoperative high beta-TG and fibrinopeptide A (FpA) are reliable indices of (a) tumor persistence in both gastric and large bowel cancer; (b) lymph node involvement in gastric much more than in large bowel cancer; (c) metastatic spreading from gastric cancer; (4) the FpA levels are proportional to the tumor mass in gastric cancer. The finding of lower plasma heparin levels in neoplastic patients, when compared with controls (20 patients having undergone abdominal surgery for extraneoplastic affections) suggests higher than conventional doses (5,000 units every 8 h s.c.) of the drug should be given to neoplastic patients in order to prevent thromboembolic bouts and possibly reduce metastatic spreading.
Abbasciano
V
V
Istituti di Patologia speciale medica, Università di Ferrara, Italia.
Guerra
S
S
Reali
M G
MG
Guglielmini
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation; D003110:Colonic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005344:Fibrinopeptide A / Q000032:analysis; D006493:Heparin / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D001620:beta-Thromboglobulin / Q000032:analysis
D005338:Fibrin Fibrinogen Degradation Products; D001620:beta-Thromboglobulin; D005344:Fibrinopeptide A; D006493:Heparin