Pneumonectomy due to lung cancer results in a more pronounced activation of coagulation system than lobectomy.
Surgical treatment of lung cancer is associated with an elevated risk of thrombo-embolic complications. The question is whether the extent of pulmonary resection influences the concentration of serum coagulation system proteins.


OBJECTIVE
This study aims to compare the blood coagulation activation parameters among patients undergoing pneumonectomy and lobectomy due to primary lung cancer.


METHODS
A prospective study was carried out in 40 patients. Of whom, 30 underwent lobectomy and 10 treated with pneumonectomy. Serum concentrations of tissue factor (TF), tissue factor pathway inhibitor (TFPI), tissue factor pathway inhibitor-activated factor X complex (TFPI/Xa), thrombin-antithrombin complex (TAT), L-selectin, E-selectin and P-selectin were measured on the first and seventh postoperative days.


RESULTS
On the first postoperative day, the results of selected proteins concentrations were similar in both groups. However, on the seventh postoperative day, significantly higher concentrations of TF, TAT complex and E-selectin were found in patients who underwent pneumonectomy (median values: TF: 182.4 pg ml(-1) vs 116.6 pg ml(-1), P=0.031; TAT: 6.2 mg ml(-1) vs 3.9 mg ml(-1), P=0.048; E-selectin 40.24 ng ml(-1) vs 26.54 ng ml(-1), P=0.049).


CONCLUSIONS
Pneumonectomy was associated with significantly higher activation of coagulation system on the seventh postoperative day than lobectomy. TAT complex, TF and E-selectin are promising markers of extensive postoperative activation of coagulation and efficacy of antithrombotic prophylaxis.
Swiniarska
Joanna
J
Department of Thoracic Surgery and Tumors, Oncology Center of Bydgoszcz, Poland.
Zekanowska
Ewa
E
Dancewicz
Maciej
M
Bella
Mariusz
M
Szczesny
Tomasz Jaroslaw
TJ
Kowalewski
Janusz
J
D000368:Aged; D000990:Antithrombin III; D001777:Blood Coagulation; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000601:surgery*; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood; D008175:Lung Neoplasms / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D019087:Selectins / Q000097:blood; D013925:Thromboplastin / Q000378:metabolism
D008074:Lipoproteins; D019087:Selectins; C046193:antithrombin III-protease complex; C051928:lipoprotein-associated coagulation inhibitor; D000990:Antithrombin III; D013925:Thromboplastin; D010447:Peptide Hydrolases