Thromb Haemost 2002; 87(03): 402-408
DOI: 10.1055/s-0037-1613017
Review Article
Schattauer GmbH

Relationship of Coagulation Test Abnormalities to Tumour Burden and Postoperative DVT in Resected Colorectal Cancer

L. H. Iversen
1   Department of Surgical Gastroenterology A, Aalborg Hospital, Denmark
,
O. Thorlacius-Ussing
1   Department of Surgical Gastroenterology A, Aalborg Hospital, Denmark
› Author Affiliations
Further Information

Publication History

Received 09 April 2001

Accepted after resubmission 26 November 2001

Publication Date:
14 December 2017 (online)

Summary

In a prospective study, coagulation test results were compared in 137 patients with colorectal cancer (CRC) and 39 subjects with benign colorectal diseases. Prothrombin fragment 1+2 (F1+2), thrombinantithrombin complex (TAT), and soluble fibrin (SF) were measured in plasma before and after surgery. CRC patients presented with significantly higher values of F1+2 and TAT than controls. Patients with localised CRC had elevated values of F1+2 and TAT, whereas patients with advanced CRC also had elevated SF values. TAT and SF levels correlated with tumour spread, and normal values virtually excluded advanced cancer. Postoperative deep venous thrombosis (DVT) was diagnosed by phlebography in 20% of the CRC patients. Preoperative values of the markers did not predict postoperative DVT, but postoperative values did.

 
  • References

  • 1 Donati MB. Cancer and thrombosis. Haemostasis 1994; 24: 128-31.
  • 2 Bauer KA, Rosenberg RD. The pathophysiology of the prethrombotic state in humans: insights gained from studies using markers of hemostatic system activation. Blood 1987; 70: 343-50.
  • 3 Falanga A, Barbui T, Rickles FR, Levine MN. Guidelines for clotting studies in cancer patients. For the Scientific and Standardization Committee of the Subcommittee on Haemostasis and Malignancy International Society of Thrombosis and Haemostasis. Thromb Haemost 1993; 70: 540-2.
  • 4 Falanga A, Ofosu FA, Cortelazzo S, Delaini F, Consonni R, Caccia R, Longatti S, Maran D, Rodeghiero F, Pogliani E. et al. Preliminary study to identify cancer patients at high risk of venous thrombosis following major surgery. Br J Haematol 1993; 85: 745-50.
  • 5 Iversen LH, Thorlacius-Ussing O, Okholm M. Soluble fibrin in plasma before and after surgery for benign and malignant colorectal disease. Thromb Res 1995; 79: 471-81.
  • 6 Iversen LH, Okholm M, Thorlacius OUssing. Pre- and postoperative state of coagulation and fibrinolysis in plasma of patients with benign and malignant colorectal disease – a preliminary study. Thromb Haemost 1996; 76: 523-8.
  • 7 Iversen LH. Coagulation and fibrinolysis in patients undergoing surgery for colorectal cancer – as assessed by sensitive markers. Ph.D.-thesis; Aalborg: 1997
  • 8 Pelzer H, Schwarz A, Stuber W. Determination of human prothrombin activation fragment 1 + 2 in plasma with an antibody against a synthetic peptide. Thromb Haemost 1991; 65: 153-9.
  • 9 Pelzer H, Schwarz A, Heimburger N. Determination of human thrombinantithrombin III complex in plasma with an enzyme-linked immunosorbent assay. Thromb Haemost 1988; 59: 101-6.
  • 10 Lill H, Spannagl M, Trauner A, Schramm W, Schuller D, Ofenloch BHaehnle, Draeger B, Naser W, Dessauer A. A new immunoassay for soluble fibrin enables a more sensitive detection of the activation state of blood coagulation in vivo. Blood Coagul Fibrinolysis 1993; 04: 97-102.
  • 11 Bland JM, Altman DG. The use of transformation when comparing two means. BMJ 1996; 312: 1153.
  • 12 Lowe GD, Rumley A, Woodward M, Morrison CE, Philippou H, Lane DA, Tunstall HPedoe. Epidemiology of coagulation factors, inhibitors and activation markers: the Third Glasgow MONICA Survey. I. Illustrative reference ranges by age, sex and hormone use. Br J Haematol 1997; 97: 775-84.
  • 13 Altman DG, Bland JM. Diagnostic tests. 1: Sensitivity and specificity. BMJ 1994; 308: 1552.
  • 14 Altman DG, Bland JM. Diagnostic tests 2: Predictive values. BMJ 1994; 309: 102.
  • 15 Mannucci PM, Bottasso B, Tripodi A, Bianchi ABonomi. Prothrombin fragment 1 + 2 and intensity of treatment with oral anticoagulants. Thromb Haemost 1991; 66: 741.
  • 16 Rahr HB, Sorensen JV. Venous thromboembolism and cancer. Blood Coagul Fibrinolysis 1992; 03: 451-60.
  • 17 Agnelli G. Venous thromboembolism and cancer: a two-way clinical association. Thromb Haemost 1997; 78: 117-20.
  • 18 Kakkar AK, de Lorenzo F, Pineo GF, Williamson RC. Venous thromboembolism and cancer. Baillieres Clin Haematol 1998; 11: 675-87.
  • 19 Lowe GD. Prediction of postoperative deep-vein thrombosis. Thromb Haemost 1997; 78: 47-52.
  • 20 Dano K, Andreasen PA, Grondahl JHansen, Kristensen P, Nielsen LS, Skriver L. Plasminogen activators, tissue degradation, and cancer. Adv Cancer Res 1985; 44: 139-266.
  • 21 Costantini V, Zacharski LR. Fibrin and cancer. Thromb Haemost 1993; 69: 406-14.
  • 22 Mulcahy HE, Duffy MJ, Gibbons D, McCarthy P, Parfrey NA, O’Donoghue DP, Sheahan K. Urokinase-type plasminogen activator and outcome in Dukes’ B colorectal cancer. Lancet 1994; 344: 583-4.
  • 23 Nielsen HJ, Pappot H, Christensen IJ, Brunner N, Thorlacius-Ussing O, Moesgaard F, Dano K, Grondahl-Hansen J. Association between plasma concentrations of plasminogen activator inhibitor-1 and survival in patients with colorectal cancer. BMJ 1998; 316: 829-30.
  • 24 Stephens RW, Nielsen HJ, Christensen IJ, Thorlacius-Ussing O, Sorensen S, Dano K, Brunner N. Plasma urokinase receptor levels in patients with colorectal cancer: relationship to prognosis. J Natl Cancer Inst 1999; 91: 869-74.
  • 25 van Wersch JW, Peters C, Ubachs HM. Haemostasis activation markers in plasma of patients with benign and malignant gynaecological tumours: a pilot study. Eur J Clin Chem Clin Biochem 1995; 33: 225-9.
  • 26 Bottasso B, Mari D, Coppola R, Santoro N, Vaglini M, Mannucci PM. Hypercoagulability and hyperfibrinolysis in patients with melanoma. Thromb Res 1996; 81: 345-52.
  • 27 Dukes CE. The classification of cancer of the rectum. J Pathol Bacteriol 1932; 35: 323-32.
  • 28 Seitz R, Rappe N, Kraus M, Immel A, Wolf M, Maasberg M, Egbring R, Pfab R, Havemann K. Activation of coagulation and fibrinolysis in patients with lung cancer: relation to tumour stage and prognosis. Blood Coagul Fibrinolysis 1993; 04: 249-54.
  • 29 Tricerri A, Vangeli M, Errani AR, Guidi L, Canetta M, Vaccarino M, De Santis C, Ipsevich F, Salvati F, Bartoloni C. Plasma thrombin-antithrombin complexes, latent coagulation disorders and metastatic spread in lung cancer: a longitudinal study. Oncology 1996; 53: 455-60.
  • 30 Falanga A, Gordon SG. Isolation and characterization of cancer procoagulant: a cysteine proteinase from malignant tissue. Biochemistry 1985; 24: 5558-67.
  • 31 Francis JL, Biggerstaff J, Amirkhosravi A. Hemostasis and malignancy. Semin Thromb Hemost 1998; 24: 93-109.
  • 32 VanDeWater L, Tracy PB, Aronson D, Mann KG, Dvorak HF. Tumor cell generation of thrombin via functional prothrombinase assembly. Cancer Res 1985; 45: 5521-5.
  • 33 Wojtukiewicz MZ, Rucinska M, Zimnoch L, Jaromin J, Piotrowski Z, Rozanska- MKudelska, Kisiel W, Kudryk BJ. Expression of prothrombin fragment 1+2 in cancer tissue as an indicator of local activation of blood coagulation. Thromb Res 2000; 97: 335-42.
  • 34 Cofrancesco E, Cortellaro M, Corradi A, Ravasi F, Bertocchi F. Coagulation activation markers in the prediction of venous thrombosis after elective hip surgery. Thromb Haemost 1997; 77: 267-9.
  • 35 Lowe GD, Haverkate F, Thompson SG, Turner RM, Bertina RM, Turpie AG, Mannucci PM. Prediction of deep vein thrombosis after elective hip replacement surgery by preoperative clinical and haemostatic variables: the CAT DVT Study. European Concerted Action on Thrombosis. Thromb Haemost 1999; 81: 879-86.