Procoagulant factors in patients with cancer.
BACKGROUND
Clotting activation and thromboembolic manifestations are common features in patients with cancer. Tumor cells can directly activate the clotting through two procoagulants: tissue factor (TF) and cancer procoagulant (CP).


OBJECTIVE
The aim was to evaluate the levels of TF and CP in patients with different tumors in order to: (1) establish an association between these markers and the tumor localization, (2) establish a correlation between the levels of procoagulants and the status of the disease, (3) evaluate if the treatment with chemotherapy induced some modifications on the levels of procoagulants, (4) evaluate the possibility of using procoagulants as predictors in the development of thrombosis.


METHODS
Sixty-one patients with different types of cancer (lung, breast, digestive and genitourinary) and 20 normal controls were included. The activity of TF and CP was studied in serum samples. Statistical analysis of the data was performed by two-tailed Fisher exact test.


RESULTS
The TF was increased in 72.5 and 0% (p < 0.01) of cancer patients and normal controls, respectively. PC was found to be increased in 88% of the cancer patients but in healthy controls it was increased in only 15% (p < 0.01). The patients with genitourinary cancer presented the highest values of both procoagulants coinciding with a major prevalence of thrombotic events. The activity CP was found in 93% of patients with stages I and II but in patients with stages II and IV disease it was found in 85% (not significant). There were no differences in the levels of both procoagulants between the patients treated with chemotherapy and those with other treatments.


CONCLUSIONS
TF and CP are elevated in patients with cancer. The highest values of both procoagulants are in the genitourinary cancer group in agreement with the greater presence of thrombosis observed in this group. Clinical follow up is important in order to determine the potential value of these procoagulants and the tendency to develop thrombosis in patients with cancer.
Molnar
Soledad
S
Division of Hematology and Oncology, Cordoba, Argentina. soledadmolnar@yahoo.com.ar
Guglielmone
Hugo
H
Lavarda
Marcelo
M
Rizzi
Maria Laura
ML
Jarchum
Gustavo
G
D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms; D016022:Case-Control Studies; D003546:Cysteine Endopeptidases / Q000097:blood*; D004067:Digestive System Neoplasms; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood*; D009367:Neoplasm Staging; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D013925:Thromboplastin / Q000032:analysis*; D013927:Thrombosis / Q000209:etiology; D014565:Urogenital Neoplasms
D009363:Neoplasm Proteins; D013925:Thromboplastin; D003546:Cysteine Endopeptidases; C030910:cancer procoagulant