Topcu Turkan Ozturk, Kavgacı Halil, Canyılmaz Emine, Orem Asim, Yaman Huseyin, Us Diler, Ozdemir Feyyaz, Aydın Fazıl
Division of Medical Oncology, School of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey.
Division of Medical Oncology, School of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey.
Biomed Pharmacother. 2015 Jul;73:19-23. doi: 10.1016/j.biopha.2015.05.003. Epub 2015 May 28.
Increased thromboembolic disorders and chemotherapy-induced thromboembolic events are well known phenomena in patients with breast cancer. Antithrombin III (AT III) inactivates thrombin, resulting in increased thrombin-antithrombin (TAT) levels. Activated factor X cleaves prothrombin and thrombin, resulting in increased levels of prothrombin fragment 1+2 (F 1+2). Increased TAT and F 1+2 levels show coagulation activation. The aim of this study was to examine plasma levels of TAT and F 1+2 and the effect of anthracycline-based chemotherapy on plasma TAT and F 1+2 in patients with operable breast cancer.
Seventy patients and 30 age-matched healthy controls were enrolled. Levels of TAT and F 1+2 were investigated before and after adjuvant chemotherapy. Basal levels (pre-chemotherapy) of TAT and F 1+2 in patients were compared with those in healthy controls and patient levels after 3 cycles of chemotherapy. Levels of TAT and F 1+2 were determined using the ELISA method.
TAT and d-dimer levels were significantly higher in patients, (P: 0.02 and P<0.001, respectively). Post-chemotherapy F 1+2 levels were higher than basal levels (P: 0.02). F 1+2 levels were higher in patients, although the difference was not statistically significant (P: 0.52). There was no difference between basal and post-chemotherapy TAT levels.
In conclusion, while higher post-chemotherapy F 1+2 levels suggest that the cumulative effect of chemotherapy increases the risk of thrombosis, TAT and d-dimer levels indicate that the effect of the cancer further increases the risk of thrombosis in patients with operable breast cancer.
血栓栓塞性疾病增加以及化疗诱导的血栓栓塞事件在乳腺癌患者中是众所周知的现象。抗凝血酶III（AT III）使凝血酶失活，导致凝血酶 - 抗凝血酶（TAT）水平升高。活化的因子X裂解凝血酶原和凝血酶，导致凝血酶原片段1 + 2（F 1+2）水平升高。TAT和F 1+2水平升高表明凝血激活。本研究的目的是检测可手术乳腺癌患者血浆中TAT和F 1+2水平以及蒽环类化疗对血浆TAT和F 1+2的影响。
纳入70例患者和30例年龄匹配的健康对照。在辅助化疗前后检测TAT和F 1+2水平。将患者的TAT和F 1+2基础水平（化疗前）与健康对照以及化疗3个周期后的患者水平进行比较。使用ELISA方法测定TAT和F 1+2水平。
患者的TAT和D - 二聚体水平显著更高（P值分别为0.02和P<0.001）。化疗后F 1+2水平高于基础水平（P值为0.02）。患者的F 1+2水平更高，尽管差异无统计学意义（P值为0.52）。化疗前和化疗后TAT水平无差异。
总之，虽然化疗后较高的F 1+2水平表明化疗的累积效应增加了血栓形成风险，但TAT和D - 二聚体水平表明癌症的影响进一步增加了可手术乳腺癌患者的血栓形成风险。
