Tas Faruk, Karabulut Senem, Bilgin Elif, Kılıc Leyla, Ciftci Rumeysa, Duranyildiz Derya
Institute of Oncology, University of Istanbul, Capa, 34390, Istanbul, Turkey,
J Gastrointest Cancer. 2013 Dec;44(4):404-9. doi: 10.1007/s12029-013-9512-8.
Activated coagulation and fibrinolytic system in cancer patients is associated with tumor stroma formation and metastasis in different cancer types. The aim of this study is to explore the correlation of blood coagulation tests for various clinicopathologic factors in patients with metastatic pancreatic adenocarcinoma (MPA).
A total of 17 MPA patients were enrolled into the study. All the patients were treatment-naïve. Pretreatment blood coagulation tests including prothrombin time, activated partial thromboplastin time (APTT), international normalized ratio (INR), D-dimer, fibrinogen levels, and platelet counts were evaluated. Control group comprised 50 age- and sex-matched individuals without history of malignancy and coagulation disorder.
Median age of diagnosis was 59 years old (range, 35-72). The plasma level of all coagulation factors revealed statistically significant difference between patient and control group (p < 0.01). Anemic patients had associated with higher D-dimer levels (p = 0.001). Similarly, the ones with elevated serum CA19-9 exhibited significantly higher D-dimer values (p = 0.011). For APTT, significant differences were found in both between gender of patients (p = 0.01) and response to chemotherapy (p = 0.01). The patients with elevated erythrocyte sedimentation rates had associated with higher INR (p = 0.05). Univariate analysis of survival revealed that the patients with unresponsive to chemotherapy (p = 0.06) and higher INR (p = 0.078) had poor overall outcome.
Serum D-dimer level is elevated among MPA patients with higher serum CA19-9 and higher INR levels seem to be a poor prognostic factor in MPA.
癌症患者体内激活的凝血和纤维蛋白溶解系统与不同癌症类型的肿瘤基质形成和转移相关。本研究旨在探讨转移性胰腺腺癌（MPA）患者各种凝血检查与临床病理因素之间的相关性。
本研究共纳入17例MPA患者。所有患者均未接受过治疗。评估了治疗前的凝血检查，包括凝血酶原时间、活化部分凝血活酶时间（APTT）、国际标准化比值（INR）、D-二聚体、纤维蛋白原水平和血小板计数。对照组包括50名年龄和性别匹配、无恶性肿瘤病史和凝血障碍的个体。
诊断时的中位年龄为59岁（范围35 - 72岁）。所有凝血因子的血浆水平在患者组和对照组之间显示出统计学上的显著差异（p < 0.01）。贫血患者的D-二聚体水平较高（p = 0.001）。同样，血清CA19-9升高的患者D-二聚体值显著更高（p = 0.011）。对于APTT，在患者性别之间（p = 0.01）和化疗反应之间（p = 0.01）均发现显著差异。红细胞沉降率升高的患者INR较高（p = 0.05）。生存的单因素分析显示，对化疗无反应的患者（p = 0.06）和INR较高的患者（p = 0.078）总体预后较差。
血清CA19-9较高的MPA患者血清D-二聚体水平升高，较高的INR水平似乎是MPA患者预后不良的因素。
