title: Role of coagulation factors in urological malignancy: A prospective, controlled study on prostate, renal and bladder cancer.
abstract: To study the behavior of specific coagulation factors in different types of non-metastatic urological cancers, and to identify their possible role as diagnostic and prognostic markers.
  
  
  
  This was a prospective controlled study, which included three cancer patient groups and a control group of healthy individuals. The cancer subgroups consisted of renal (n = 44), prostate (n = 56) and bladder cancer (n = 47). We excluded patients receiving anticoagulant therapy, or with significant comorbidity. In all patients, certain coagulation parameters were measured (prothrombin time, international normalized ratio, partial thromboplastin time, D-dimers, fibrinogen, F1 + 2, thrombin-antithrombin complex). Statistical analysis was carried out to explore the association of hemostasis markers with tumor-nodes-metastasis stage, Gleason score, transitional cell carcinoma grade, Fuhrman grade and prostate-specific antigen.
  
  
  
  Our final sample consisted in 58 control patients and 147 patients with urological cancer. We found specific patterns of increased coagulation factors in the different cancers that were statistically significant. Renal cancer showed increased levels of D-dimers, partial thromboplastin time and fibrinogen. D-dimers and fibrinogen were increased in prostate cancer; whereas in bladder cancer, only fibrinogen was elevated. Correlations were found between certain factors and tumor stage and grading, with D-dimers being independently associated with higher tumor grade. Thrombin-antithrombin complex was associated with Gleason score. Furthermore, D-dimers, fibrinogen and F1 + 2 were associated with higher tumor stages (II-IV).
  
  
  
  The coagulation pathway seems to be activated in urological malignancies. Specific panels of coagulation factors might play a role as screening or prognostic tools in earlier stages of renal, prostate and bladder cancer. Further research should also focus on their role in the association of cancer with thromboembolic events.
authors.affiliation: Colchester Hospital University Foundation Trust, Essex, UK.
authors.forename: Aristeidis
authors.initials: A
authors.lastname: Alevizopoulos
authors.affiliation: Section of Urology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.|Center for Minimally Invasive Urological Surgery, Athens Medical Center, Athens, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Tyritzis
authors.affiliation: Facharzt fur Urologie, Diakonissenkrankenhaus Flensburg, Flensburg, Germany.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Leotsakos
authors.affiliation: Blood Transfusion Center, National Reference Center for Congenital Bleeding Diseases, Laiko General Hospital, Athens, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Anastasopoulou
authors.affiliation: 1st University Department of Urology, Laiko General Hospital, National and Kapodistrian Athens University, Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Pournaras
authors.affiliation: Blood Transfusion Center, National Reference Center for Congenital Bleeding Diseases, Laiko General Hospital, Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Kotsis
authors.affiliation: Blood Transfusion Center, National Reference Center for Congenital Bleeding Diseases, Laiko General Hospital, Athens, Greece.
authors.forename: Olga
authors.initials: O
authors.lastname: Katsarou
authors.affiliation: 1st University Department of Urology, Laiko General Hospital, National and Kapodistrian Athens University, Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Alamanis
authors.affiliation: 1st University Department of Urology, Laiko General Hospital, National and Kapodistrian Athens University, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Stravodimos
authors.affiliation: 1st University Department of Urology, Laiko General Hospital, National and Kapodistrian Athens University, Athens, Greece.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Constantinides
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D001779:Blood Coagulation Factors / Q000032:analysis*; D001780:Blood Coagulation Tests; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood* / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000097:blood* / Q000150:complications / Q000473:pathology; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D001749:Urinary Bladder Neoplasms / Q000097:blood* / Q000150:complications / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D001779:Blood Coagulation Factors
keywords: bladder cancer; hemostasis factors; prostate cancer; renal cancer; tumor markers