Coagulative system activation and fibrinolytic system inhibition activities arise from tumoral draining vein in colon carcinoma.
Hypercoagulability and activation/inhibition of the fibrinolytic system have been observed in abdominal cancer surgery. Because surgery itself and also neoplastic diseases are associated with these situations, a method for separating the origin of these two processes was designed. Eighteen patients with colon cancer who underwent a surgical procedure were studied: Immediately before surgery blood was taken from a peripheral vein. During the surgical procedure, before the exclusion of tumoral tissue from general circulation and at the same time of a second peripheral vein blood sample, a blood sample was taken from the main tumoral draining vein. Platelet-poor plasma samples were aliquoted and stored at -72 degrees C, ready for analytical procedures.


RESULTS
A moderate activation of the fibrinolytic system during surgery was observed, expressed by elevation of tissue plasminogen activator (t-PA) (P<.05) and D-dimer (DD) (P<.05) levels, without changes in fibrinogen (FG), plasminogen (PG) or antiplasmin (AP) levels. There were no modifications in antithrombin III (AT-III) and protein C (PC) levels. In the tumoral draining vein samples, there was a high elevation of levels of thrombin-antithrombin III complexes (TAT) (P<.001) and PAI-1 (P<.01), compared with the second sample peripheral vein. There was no difference between peripheral and tumoral vein sample levels of AT-III, PC, FG, DD, PG and AP.


CONCLUSIONS
The tumour itself is the origin of hypercoagulability (TAT) and fibrinolytic system inhibition (PAI-1); the surgical procedure elicits an evident though moderate activation of the fibrinolytic system (t-PA and DD elevation).
Garcia-Avello
A
A
Haematology Department, Hospital Ramón y Cajal, Carretera de Colmenar s/n, 28034 Madrid, Spain.
Galindo-Alvarez
J
J
Martinez-Molina
E
E
Cesar-Perez
J
J
Navarro
J L
JL
D000368:Aged; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D003110:Colonic Neoplasms / Q000097:blood* / Q000150:complications / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005342:Fibrinolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D019851:Thrombophilia / Q000097:blood / Q000209:etiology* / Q000473:pathology; D010959:Tissue Plasminogen Activator / Q000097:blood; D014680:Veins
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D017395:Plasminogen Activator Inhibitor 1; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; D000990:Antithrombin III; D010447:Peptide Hydrolases; D010959:Tissue Plasminogen Activator