title: Prognostic impact of an activation of coagulation in lung cancer.
abstract: BACKGROUND
  There is evidence that activation of coagulation by influencing tumour biology may have impact on clinical course of lung cancer.
  
  
  METHODS
  We measured the activation markers thrombin-antithrombin complex (TAT) and prothrombin fragment F1 + 2 in 99 lung cancer patients immediately after diagnosis, before antineoplastic treatment. Outcome was assessed at the end of appropriate standard primary therapy (four to six courses of chemotherapy, surgery or radiation).
  
  
  CONCLUSIONS
  The activation markers (means +/- SEM) were lower in the 33 responders (RSP; complete or partial remission) than in the 66 non-responders (NRSP): TAT 3.96 +/- 0.48 vs. 9.69 +/- 1.57 micrograms/l (P < 0.001), and F1 + 2 1.09 +/- 0.09 vs. 1.64 +/- 0.25 nmol/l (P < 0.05). TAT levels were > 6 micrograms/l in 30 of 66 (45%) NRSP, but only 4 of 33 (12%) RSP. 88% of patients with TAT < or = 6 micrograms/l achieved remission, and 45% with TAT > 6 micrograms/l (P = 0.0014). In the subgroup of 46 patients with advanced disease, the six RSP showed lower TAT than the 40 NRSP: 4.65 +/- 0.94 vs. 11.92 +/- 2.49 micrograms/l (P < 0.01); one of six (17%) RSP, but 21 of 40 (53%) NRSP showed TAT > 6 micrograms/l. These data suggest that in lung cancer the activation of coagulation is an independent prognostic factor, since TAT levels were different between RSP and NRSP, also within the homogeneously unfavourable metastatic subgroup. It should be further studied, whether TAT can identify patients, whose prognosis could be improved by anticoagulation as an adjunct to standard antineoplastic therapy.
authors.affiliation: Philipps University Hospitals, Department of Haematology/Oncology, Marburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Seitz
authors.forename: H H
authors.initials: HH
authors.lastname: Heidtmann
authors.forename: M
authors.initials: M
authors.lastname: Wolf
authors.forename: A
authors.initials: A
authors.lastname: Immel
authors.forename: R
authors.initials: R
authors.lastname: Egbring
mesh_terms: D000990:Antithrombin III / Q000032:analysis*; D001777:Blood Coagulation; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood*; D010447:Peptide Hydrolases / Q000032:analysis*; D011379:Prognosis; D011446:Prospective Studies
chemical_list: C046193:antithrombin III-protease complex; D000990:Antithrombin III; D010447:Peptide Hydrolases