Alteration of haemostasis in non-metastatic gastric cancer.
BACKGROUND
Cancer is one of the most common acquired causes of venous thromboembolism.


OBJECTIVE
To evaluate haemostasis disorders in patients with non-metastatic gastric cancer.


METHODS
We studied 11 patients with non-metastatic gastric cancer (9 males and 2 females, median age 54 years) and 20 healthy subjects (15 males and 5 females, median age 48 years) control. We measured prothrombin time, activated partial thromboplastin time, coagulation time, clot lysis time, fibrinogen, clotting factors (II, VII, VIII, IX, X), C protein, S protein, AT III, activated protein C resistance, prothrombin 1+2 fragment, tissue plasminogen activator and D-Dimer in all subjects.


RESULTS
Fibrinogen plasma levels were significantly higher in patients with non-metastatic gastric cancer than in control group (505+/-24 mg/dl vs 336+/-30 mg/dl, p<0.001). We also found a significant increase in prothrombin 1+2 fragment plasma concentration compared with controls (3.8+/-0.6 nM vs 0.83+/-0.09 nM, p<0.001). Plasma D-dimer levels were 20-fold higher in patients with non-metastatic gastric cancer compared with controls (9.57+/-0.4 ng/dl vs 0.4+/-0.05 ng/dl, p<0.001). Also tissue plasminogen activator was significantly higher in gastric cancer patients than in controls (20.8+/-2.32 ng/ml vs 9.1+/-1.37 ng/ml, p<0.01). Finally clot lysis time was significantly accelerated in gastric cancer patients compared with control subjects (81+/-37 min vs 233+/-74 min, p<0.01).


CONCLUSIONS
Patients with non-metastatic gastric cancer are at risk for thrombotic events due to the combined increase in fibrinogen plasma levels and thrombin formation.
Di Micco
P
P
Division of General Medicine and Hepatology, Second University of Naples, Italy. pdimicco@libero.it
Romano
M
M
Niglio
A
A
Nozzolillo
P
P
Federico
A
A
Petronella
P
P
Nunziata
L
L
Di Micco
B
B
Torella
R
R
D020016:Activated Protein C Resistance; D016022:Case-Control Studies; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis*; D005342:Fibrinolysis; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011517:Prothrombin Time; D013274:Stomach Neoplasms / Q000097:blood* / Q000150:complications; D013917:Thrombin / Q000032:analysis*; D013923:Thromboembolism / Q000097:blood* / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000032:analysis
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D005340:Fibrinogen; D013917:Thrombin; D010959:Tissue Plasminogen Activator