Lundbech Mikkel, Krag Andreas Engel, Iversen Lene Hjerrild, Brandsborg Birgitte, Hvas Anne-Mette
Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus N, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Pleura Peritoneum. 2024 Nov 6;9(4):149-154. doi: 10.1515/pp-2024-0009. eCollection 2024 Dec.
Cancer cells can activate coagulation and inhibit fibrinolysis. The aim was to investigate the association between the burden of peritoneal metastases from colorectal cancer (PM-CRC) and biomarkers reflecting thrombin generation and fibrinolysis.
A cohort of 55 patients with PM-CRC scheduled for cytoreductive surgery. Patients were grouped by the peritoneal cancer index (PCI) assessed intraoperatively into limited PM-CRC (PCI≤15) and extensive PM-CRC (PCI>15). Blood samples were obtained before surgery. Thrombin generation was measured by thrombin-antithrombin complex (TAT) and prothrombin fragment 1+2 (F1+2), and ex vivo by the endogenous thrombin potential (ETP). Fibrinolysis was analyzed with fibrin clot lysis assay, fibrinogen, and D-dimer.
Non-significantly decreased thrombin generation by F1+2 (p=0.72), TAT (p=0.32), and ETP (p=0.19) were observed in patients with extensive PM-CRC (n=9) compared with limited PM-CRC (n=46). Non-significantly prolonged 50 % clot lysis time were found in patients with extensive PM-CRC than in patients with limited PM-CRC.
Minor non-significant differences in thrombin generation and fibrinolysis were found between patients with extensive PM-CRC and limited PM-CRC. Thus, increased peritoneal metastatic burden from colorectal cancer does not seem to affect thrombin generation and fibrinolysis.
癌细胞可激活凝血并抑制纤维蛋白溶解。本研究旨在探讨结直肠癌腹膜转移（PM-CRC）负担与反映凝血酶生成和纤维蛋白溶解的生物标志物之间的关联。
纳入55例计划接受减瘤手术的PM-CRC患者。根据术中评估的腹膜癌指数（PCI）将患者分为局限性PM-CRC（PCI≤15）和广泛性PM-CRC（PCI>15）。术前采集血样。通过凝血酶-抗凝血酶复合物（TAT）和凝血酶原片段1+2（F1+2）测定凝血酶生成，并通过内源性凝血酶潜力（ETP）进行体外测定。采用纤维蛋白凝块溶解试验、纤维蛋白原和D-二聚体分析纤维蛋白溶解情况。
与局限性PM-CRC患者（n=46）相比，广泛性PM-CRC患者（n=9）的F1+2（p=0.72）、TAT（p=0.32）和ETP（p=0.19）凝血酶生成呈非显著性降低。广泛性PM-CRC患者的50%凝块溶解时间比局限性PM-CRC患者非显著性延长。
广泛性PM-CRC患者和局限性PM-CRC患者在凝血酶生成和纤维蛋白溶解方面存在微小的非显著性差异。因此，结直肠癌腹膜转移负担增加似乎并不影响凝血酶生成和纤维蛋白溶解。
