title: The effect of cadmium on the coagulation and fibrinolytic system in women with uterine endometrial cancer and myoma.
abstract: OBJECTIVE
  Cadmium (Cd) is a persistent and widespread environmental pollutant, which may constitute a potential risk factor for hormone-dependent tumors such as endometrial cancer. The vascular endothelium is an important target of cadmium toxicity, which may interfere with the coagulation cascade and fibrinolytic system. The aim of this research was to investigate whether in female patients with uterine endometrial cancer or myoma in comparison to healthy women, the concentration of cadmium in blood affects the process of coagulation and fibrinolysis.
  
  
  METHODS
  The study group comprised 91 women: 35 healthy (A-control), 39 with uterine myoma (B) and 17 with endometrial cancer (C), in which blood cadmium concentrations (BCd), coagulation and selected fibrinolysis parameters in plasma were assayed.
  
  
  RESULTS
  In the women with myoma and especially in those with endometrial cancer disturbances in coagulation and fibrinolysis were detected when compared to the healthy women. In the group of women with endometrial cancer significant changes in prothrombin index, levels of fibrinogen, fibrin D-dimer and t-PA were observed. Whereas, in the patients with myoma significant changes in prothrombin time, index of vWillebrand Factor and fibrin D-dimer level were noted. Mean BCd concentrations in subsequent groups were as follows: B - 0.91±0.81; C - 0.78±0.45 μg Cd/l and did not differ significantly in comparison with the control group (0.86±0.35 μg Cd/l). However, in each study group smokers had approximately twice as high BCd as non-smokers. Studies also showed significant associations between BCd and fibrinogen level and thrombin time among the women with myoma and endometrial cancer, as well as in healthy women. Moreover, thrombin time significantly correlated with fibrinogen level in the women studied.
  
  
  CONCLUSIONS
  In the patients with myoma and especially in these with endometrial cancer disturbances in coagulation and fibrinolysis parameters leading to hypercoagulability were detected. Exposure to cadmium can be one of the factors inducing these changes.
authors.affiliation: Department of Toxicology, Faculty of Pharmacy, Medical University of Lodz, Łódź, Poland. marzenna.nasiadek@umed.lodz.pl
authors.forename: Marzenna
authors.initials: M
authors.lastname: Nasiadek
authors.forename: Anna
authors.initials: A
authors.lastname: Kilanowicz
authors.forename: Adam
authors.initials: A
authors.lastname: Darago
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lazarenkow
authors.forename: Marta
authors.initials: M
authors.lastname: Michalska
mesh_terms: D000328:Adult; D000368:Aged; D001777:Blood Coagulation; D002104:Cadmium / Q000097:blood*; D016022:Case-Control Studies; D016889:Endometrial Neoplasms / Q000097:blood / Q000503:physiopathology*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis; D006801:Humans; D007889:Leiomyoma / Q000097:blood / Q000503:physiopathology*; D008875:Middle Aged; D011517:Prothrombin Time; D010959:Tissue Plasminogen Activator / Q000097:blood; D055815:Young Adult; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D014841:von Willebrand Factor; D002104:Cadmium; D010959:Tissue Plasminogen Activator