title: Clinical and Prognostic Significance of Coagulation Assays in Pancreatic Cancer Patients With Absence of Venous Thromboembolism.
abstract: OBJECTIVE
  Activation of coagulation and fibrinolysis is frequently observed in patients with cancer, even with absence of thrombosis. Furthermore, plasma coagulation parameters were associated with tumor progression, metastasis, and prognosis. Few studies have investigated these associations in pancreatic cancer (PA). This study aimed to investigate the clinical and prognostic significance of various plasma coagulation tests in PA patients with absence of venous thromboembolism (VTE).
  
  
  METHODS
  A total of 139 PA patients with the absence of VTE were included in the analysis. Patients were followed up for at least 12 months until death. Pretreatment coagulation parameters including prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (F), antithrombin-III (AT-III), protein C (PC), factor-VIII (F-VIII), and D-dimer (DD) were evaluated. A total of 40 age-matched and sex-matched healthy individuals without coagulation disorder were enrolled as the control group.
  
  
  RESULTS
  Patients were inclined to have higher levels of PT, INR, APTT, F, F-VIII, and DD and lower levels of AT-III and PC than the control group (P<0.01 for all, except P=0.022 for INR and P=0.015 for AT-III). Patients with advanced tumor stages were likely to have higher median DD levels and lower AT-III levels than the control group (P=0.005 and P<0.001, respectively). DD levels were higher in patients with advanced pathology grade (P<0.001). Plasma DD levels (hazards ratio=1.71; 95% confidence interval, 1.07-2.73; P=0.025) were identified as the significantly independent prognostic predictors.
  
  
  CONCLUSIONS
  PA patients are susceptible to activation of hemostasis system. Pretreatment plasma DD level was a potential predictor of prognosis in PA patients without VTE.
authors.affiliation: *Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy †Tianjin Heping Obstetric and Gynecology Hospital, Tianjin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.forename: He
authors.initials: H
authors.lastname: Ren
authors.forename: Chun-Tao
authors.initials: CT
authors.lastname: Gao
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Ma
authors.forename: Lin
authors.initials: L
authors.lastname: Luo
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: Peng
authors.initials: P
authors.lastname: Jin
authors.forename: Ji-Hui
authors.initials: JH
authors.lastname: Hao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III / Q000378:metabolism; D001780:Blood Coagulation Tests; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood* / Q000401:mortality / Q000473:pathology; D016022:Case-Control Studies; D015331:Cohort Studies; D018450:Disease Progression; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D010314:Partial Thromboplastin Time; D011379:Prognosis; D016016:Proportional Hazards Models; D011486:Protein C / Q000378:metabolism; D011517:Prothrombin Time; D012189:Retrospective Studies; D054556:Venous Thromboembolism / Q000097:blood
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; C036309:fibrin fragment D; D000990:Antithrombin III; D005169:Factor VIII; D005340:Fibrinogen