Markers of Activated Hemostasis and Fibrinolysis in Patients with Pulmonary Malignancies: Comparison of Plasma Levels in Central Venous and Pulmonary Venous Blood

• Published in: Thrombosis research Vol. 97; no. 3; pp. 105 - 111
• Main Authors: Kalweit, Gerhard A, Feindt, Peter, Micek, Mario, Gams, Emmeran, Hellstern, Peter
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Ltd 01.02.2000; Elsevier Science
• Subjects: Activated hemostasis; Aged; Antifibrinolytic Agents - blood; Antithrombin III - analysis; Biological and medical sciences; Biomarkers - blood; Blood Coagulation; D-dimers; Female; Fibrin Fibrinogen Degradation Products - analysis; Fibrinolysis - physiology; Fibrinolysis, Pulmonary malignancies; Hemostasis - physiology; Humans; Lung Neoplasms - blood; Lung Neoplasms - mortality; Male; Markers of thrombin generation; Medical sciences; Middle Aged; Peptide Fragments - analysis; Peptide Hydrolases - analysis; Pneumology; Pneumonectomy; Protein Precursors - analysis; Prothrombin - analysis; Pulmonary Veins - chemistry; Pulmonary Veins - physiology; Survival Rate; Thrombophilia; Tumors of the respiratory system and mediastinum; Vena Cava, Superior - chemistry; D-dimers; FVII, factor VII; F1+2, prothrombin fragment 1+2; Fibrinolysis, Pulmonary malignancies; SCC, squamous cell carcinoma; AC, adenocarcinoma; Markers of thrombin generation; TAT, thrombin–antithrombin complex; Activated hemostasis; D-D, D-dimer; Human; Lung disease; Pathophysiology; Respiratory disease; Hemostasis; Biological marker; Bronchus disease; Malignant tumor; Fibrinolysis; Bronchopulmonary; Central vein; Pulmonary vein
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/S0049-3848(99)00161-9

Malignancy frequently is accompanied by activated coagulation and fibrinolysis indicating a hypercoagulable state. The purpose of our study was to estimate the contribution of local tumor-induced mechanisms to the activation of hemostasis and fibrinolysis. In a prospective study, we compared the plasma levels of thrombin-antithrombin complexes, prothrombin fragment 1+2, and D-dimers in blood samples that simultaneously were drawn from the superior vena cava and the pulmonary vein of a tumor-bearing pulmonary lobe. Samples from the superior vena cava were drawn before operation and served as controls. After thoracotomy, a second group of samples was simultaneously taken from the pulmonary veins of the tumor-bearing lobe and the superior vena cava. Forty-five patients with pulmonary malignancies were included (25 adenocarcinomas and 20 squamous cell carcinomas). There were no significant differences of thrombin-antithrombin complexes, prothrombin fragment 1+2, and D-dimers levels in patients suffering from adenocarcinoma and from squamous cell carcinoma. Intraoperatively, prothrombin fragment 1+2 and D-dimers levels were markedly increased when compared with the preoperative values ( p<0.0001). There was no increase of thrombin-antithrombin complexes levels due to the operative traumatization. Prothrombin fragment 1+2, thrombin-antithrombin complexes, and D-dimers plasma levels were significantly higher in the pulmonary venous blood than in the blood simultaneously drawn from the superior vena cava ( p<0.0001). Our findings indicate that malignant lung tumors directly contribute to the activation of hemostasis and fibrinolysis in these clinical settings.