Alevizopoulos Aristeidis, Tyritzis Stavros, Leotsakos Ioannis, Anastasopoulou Ioanna, Pournaras Christos, Kotsis Paraskevi, Katsarou Olga, Alamanis Christos, Stravodimos Konstantinos, Constantinides Constantinos
Colchester Hospital University Foundation Trust, Essex, UK.
Section of Urology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Int J Urol. 2017 Feb;24(2):130-136. doi: 10.1111/iju.13271. Epub 2016 Dec 22.
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.
研究特定凝血因子在不同类型非转移性泌尿系统癌症中的表现，并确定它们作为诊断和预后标志物的潜在作用。
这是一项前瞻性对照研究，包括三个癌症患者组和一个健康个体对照组。癌症亚组包括肾癌（n = 44）、前列腺癌（n = 56）和膀胱癌（n = 47）。我们排除了接受抗凝治疗或有严重合并症的患者。对所有患者测量了某些凝血参数（凝血酶原时间、国际标准化比值、活化部分凝血活酶时间、D - 二聚体、纤维蛋白原、F1 + 2、凝血酶 - 抗凝血酶复合物）。进行统计分析以探讨止血标志物与肿瘤 - 淋巴结 - 转移分期、 Gleason评分、移行细胞癌分级、Fuhrman分级和前列腺特异性抗原之间的关联。
我们的最终样本包括58名对照患者和147名泌尿系统癌症患者。我们发现在不同癌症中凝血因子升高的特定模式具有统计学意义。肾癌显示D - 二聚体、活化部分凝血活酶时间和纤维蛋白原水平升高。前列腺癌中D - 二聚体和纤维蛋白原升高；而在膀胱癌中，只有纤维蛋白原升高。发现某些因素与肿瘤分期和分级之间存在相关性，D - 二聚体与较高的肿瘤分级独立相关。凝血酶 - 抗凝血酶复合物与Gleason评分相关。此外，D - 二聚体、纤维蛋白原和F1 + 2与较高的肿瘤分期（II - IV期）相关。
凝血途径似乎在泌尿系统恶性肿瘤中被激活。特定的凝血因子组合可能在肾癌、前列腺癌和膀胱癌的早期阶段作为筛查或预后工具发挥作用。进一步的研究还应关注它们在癌症与血栓栓塞事件关联中的作用。
