Seitz R, Rappe N, Kraus M, Immel A, Wolf M, Maasberg M, Egbring R, Pfab R, Havemann K
Department of Internal Medicine, Philipps University Hospitals, Marburg, Germany.
Blood Coagul Fibrinolysis. 1993 Apr;4(2):249-54. doi: 10.1097/00001721-199304000-00006.
Activation of coagulation and fibrinolysis within tumour tissues is thought to be associated with tumour growth, angiogenesis, and metastasis. The plasma levels of markers of thrombin and plasmin generation are sensitive tools for monitoring activation of coagulation and fibrinolysis. We studied 47 patients with histologically confirmed lung cancer, 15 with small cell (SCLC) and 32 with non-small cell lung cancer (NSCLC). The plasma levels of the following markers were assessed:thrombin-antithrombin III complex (TAT), prothrombin activation fragment F1 + 2, plasmin-alpha 2-antiplasmin complex (PAP) and the split product from cross-linked fibrin, D-dimer. The first sample was obtained before receiving any specific antineoplastic treatment. The patients were followed thereafter until treatment was terminated. There was no difference in activation markers between patients with SCLC and NSCLC. Comparing patients with limited disease to those with extensive disease, there were significant differences in TAT (median 3.0 (1.9-9.8) vs 5.3 (1.8-35.6) micrograms/l,P = 0.021) and D-dimer (569 (135-1948) vs 1288 (120-2221) micrograms/l, P = 0.014). According to the response to subsequent treatment, those who achieved complete or partial tumour remission had significantly lower baseline levels samples than non-responders (TAT 2.9 (1.9-4.0) vs 4.7 (1.8-35.6) micrograms/l,P = 0.0047;D-dimer 527 (135-1149) vs 1242 (120-2221) micrograms/l, P = 0.0013). Thus, the increase of TAT and D-dimer appears to be related to tumour spread. The results suggest that high levels of these markers might be a sign of unfavourable prognosis in patients with lung cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
肿瘤组织内凝血和纤维蛋白溶解的激活被认为与肿瘤生长、血管生成和转移有关。凝血酶和纤溶酶生成标志物的血浆水平是监测凝血和纤维蛋白溶解激活的敏感工具。我们研究了47例经组织学确诊的肺癌患者，其中15例为小细胞肺癌（SCLC），32例为非小细胞肺癌（NSCLC）。评估了以下标志物的血浆水平：凝血酶 - 抗凝血酶III复合物（TAT）、凝血酶原激活片段F1 + 2、纤溶酶 - α2 - 抗纤溶酶复合物（PAP）以及交联纤维蛋白的裂解产物D - 二聚体。第一个样本在接受任何特异性抗肿瘤治疗之前采集。此后对患者进行随访直至治疗结束。SCLC患者和NSCLC患者的激活标志物没有差异。将疾病局限期患者与广泛期患者进行比较，TAT（中位数3.0（1.9 - 9.8）对5.3（1.8 - 35.6）微克/升，P = 0.021）和D - 二聚体（569（135 - 1948）对1288（120 - 2221）微克/升，P = 0.014）存在显著差异。根据后续治疗反应，实现肿瘤完全或部分缓解的患者基线水平样本显著低于无反应者（TAT 2.9（1.9 - 4.0）对4.7（1.8 - 35.6）微克/升，P = 0.0047；D - 二聚体527（135 - 1149）对1242（120 - 2221）微克/升，P = 0.0013）。因此，TAT和D - 二聚体的升高似乎与肿瘤扩散有关。结果表明，这些标志物的高水平可能是肺癌患者预后不良的一个迹象。（摘要截断于250字）
