title: D-dimer and international normalized ratio (INR) are correlated with tumor markers and disease stage in colorectal cancer patients.
abstract: BACKGROUND
  The aim of this study is to evaluate the correlation of coagulation tests with various clinicopathological variables and tumor markers among colorectal cancer (CRC) patients.
  
  
  METHODS
  Ninety-four CRC patients were included for evaluation of clinicopathological factors, coagulation assays and tumor marker levels.
  
  
  RESULTS
  Metastatic disease was related with elevated INR (p= 0.03). Stage III patients had higher D-dimer values compared with stage II patients (p= 0.03). Correlation of tumor markers indicated a tendency towards elevated D-dimer levels for CEA values higher than median (p= 0.01). High CA 19-9 levels were also associated with higher INR (p= 0.007). Elderly age, distant metastasis, high CEA, CA-19-9 and LDH levels were associated with poorer overall-survival. CEA level was the only independent prognostic factor in multivariate analysis.
  
  
  CONCLUSIONS
  Coagulation assays can be utilized as predictors of disease extent in CRC. Elevated D-dimer and INR values may indicate higher disease stage. Correlation of D-dimer levels with CEA supports their value for assessing tumor burden.
authors: Medical Oncology Department, Firat University Hospital, Elazig, Turkey.
authors: Leyla
authors: L
authors: Kilic
authors: Medical Oncology Department, Institute of Oncology, Istanbul University, Capa, Istanbul, Turkey.
authors: Ibrahim
authors: I
authors: Yildiz
authors: Medical Oncology Department, Institute of Oncology, Istanbul University, Capa, Istanbul, Turkey.
authors: Fatma Karagoz
authors: FK
authors: Sen
authors: Agri Hamur State Hospital, Internal Medicine Clinic, Hamur, Agri, Turkey.
authors: Mustafa Genco
authors: MG
authors: Erdem
authors: Biochemistry Department, Institute of Oncology, Istanbul University, Capa, Istanbul, Turkey.
authors: Murat
authors: M
authors: Serilmez
authors: Medical Oncology Department, Institute of Oncology, Istanbul University, Capa, Istanbul, Turkey.
authors: Serkan
authors: S
authors: Keskin
authors: Medical Oncology Department, Institute of Oncology, Istanbul University, Capa, Istanbul, Turkey.
authors: Rumeysa
authors: R
authors: Ciftci
authors: Medical Oncology Department, Institute of Oncology, Istanbul University, Capa, Istanbul, Turkey.
authors: Senem
authors: S
authors: Karabulut
authors: Medical Oncology Department, Bedii Gorbon Oncology Center, Avrupa Florence Nightingale Hospital, Sisli, Istanbul, Turkey.
authors: Cetin
authors: C
authors: Ordu
authors: Biochemistry Department, Institute of Oncology, Istanbul University, Capa, Istanbul, Turkey.
authors: Derya
authors: D
authors: Duranyildiz
authors: Medical Oncology Department, Institute of Oncology, Istanbul University, Capa, Istanbul, Turkey.
authors: Faruk
authors: F
authors: Tas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001777:Blood Coagulation / Q000235:genetics; D018395:CA-19-9 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000473:pathology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D019934:International Normalized Ratio; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D007770:L-Lactate Dehydrogenase
keywords: CA 19-9; CEA; D-dimer; Tumor marker; coagulation; colon cancer