title: Selected hemostatic parameters in patients with pancreatic tumors.
abstract: BACKGROUND
  Recent experimental studies have suggested that various coagulation-related molecules may be important players in the development and progression of pancreatic cancer. However, these findings have not yet been verified in a clinical setting.
  
  
  METHODS
  In this study, we comprehensively examined the levels of multiple hemostatic substances, including prothrombin, antithrombin, plasminogen, thrombin-anti-thrombin (TAT) and plasmin-anti-plasmin (PAP) complexes, as well as, soluble CD40 (sCD40) in patients diagnosed with pancreatic cancer (n = 37) or other tumors (neuroendocrine neoplasms - NEN [n = 7] or solid pseudopapillary tumors-SPT [n = 3]), and healthy individuals (n = 31).
  
  
  RESULTS
  We found significantly higher anti-thrombin, PAP and sCD40 levels in patients with pancreatic cancer compared to healthy controls and patients diagnosed with other types of pancreatic tumors (for all, at least p < 0.05). Cancer patients had lower plasminogen concentrations than individuals from the other analyzed groups (for both, p < 0.05). None of the examined coagulation-related parameters was significantly associated with neither systemic sCD40 concentrations nor clinical staging of malignancy. Levels of analyzed molecules were comparable between pancreatic cancer patients presenting with early and advanced disease. Moreover, our study identified a potential diagnostic value of prothrombin/TAT and anti-thrombin/TAT coefficients in detection of pancreatic cancer in humans. However, both of these were inferior to currently used marker-CA19.9.
  
  
  CONCLUSIONS
  Subclinical hemostatic alterations (mainly in plasmin-related molecules) i) appear as soon as during the earliest stages of the pancreatic adenocarcinoma development in humans, ii) do not seem to alter within progression of the disease nor are associated with clinical staging, iii) are not observed in patients with other types of pancreatic tumors, as well as, iv) do not seem to be associated with elevated sCD40 concentrations in pancreatic cancer patients. Moreover, examined thrombin- and plasmin-related substances do not appear to possess a sufficient diagnostic value to serve as makers of pancreatic adenocarcinoma in humans.
authors: Department of Gastroenterology, Pomeranian Medical University in Szczecin Poland.
authors: Anna
authors: A
authors: Deskur
authors: Department of Medical Analytics, Pomeranian Medical University in Szczecin Poland.
authors: Daria
authors: D
authors: Sałata
authors: Department of Medical Analytics, Pomeranian Medical University in Szczecin Poland.
authors: Marta
authors: M
authors: Budkowska
authors: Department of Medical Analytics, Pomeranian Medical University in Szczecin Poland.
authors: Barbara
authors: B
authors: Dołęgowska
authors: Department of Gastroenterology, Pomeranian Medical University in Szczecin Poland.
authors: Teresa
authors: T
authors: Starzyńska
authors: Department of Public Health, University of Zielona Góra Poland.
authors: Wojciech
authors: W
authors: Błogowski
keywords: Hemostasis; neuroendocrine tumors; pancreatic cancer; plasmin; thrombin
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