A Study On Thrombosis-related Markers In Pulmonary Cancer And Ovarian Cancer Patients

Thrombosis is a common complication of malignancy and the second cause of death in cancer patients. The incidence rate of venous thrombosis of ovarian cancer and lung cancer were 10.6% and 4.4%.A series of pathology, laboratory and clinical research had shown that change in the blood coagulation, anticoagulation, fibrinolytic system is closely related to malignancy. We determined parameters such as activity of plasma coagulation factorⅧ(FⅧ:C)and activity of plasma coagulation factor IX(FIX:C), antigen contents of plasma von Willebrand factor (vWF:Ag) and plasma levels of thrombus precursor protein(TpP) in this experiment to detect changes of the four reflected prethrombotic status indicators in the course of lung cancer and ovarian cancer.Objective1. To investigate the changes of FⅧ:C and FIX:C, vWF:Ag and TpP levels in patients with pulmonary cancer and ovrian cancer and their correlation with stage and type of lung cancer and ovrian cancer.2. To investigate the changes of FⅧ:C and FIX:C, vWF:Ag and TpP levels and their clinical significancy in patients with pulmonary cancer and ovrian cancer before and after surgery.3. To provide a new target for the prevention,diagnosis and treatment of prethrombotic state in pulmonary cancer patients and ovrian cancer patients by study on FⅧ:C and FIX:C, vWF:Ag and TpP levels in patients with pulmonary cancer and ovrian cancer .Methods38 patients with pulmonary cancer and 11 patients with ovrian cancer were diagnosed according to pathology or cytology and enrolled in this study ,including 26 male and 23 female, average 61±8.9 years old .20 healthy individuals were taken as control, including 11 male and 9 female, average 57±8.2 years old . The three groups had no significant differences in age. According to TNM stage and clinical stage of lung cancer , 38 patients were divided into two groups : 13 cases in theⅠ～Ⅱstage pulmonary cancer , 25 cases in theⅢ～Ⅳstage of pulmonary cancer . The histologic type was squamous-cell carcinoma in 11 patients , adenocarcinoma in 21 patients and small cell lung cancer in 6 patients. 4ml peripheral blood was collected by sodium citrate (1:9) .Plasma was separated and FⅧ:C and FIX:C were tested by solidification on the Stago Campct automatic coagulometer . Plasma vWF:Ag and TpP levels were detected by enzyme-linked immunosorbent assay (ELISA).The patients who had had operation treatment were phlebotomized on the seventh day after surgery. 4ml peripheral blood was collected and anticoagulated by sodium citrate anticoagulation solution (1:9) ,dealing with the former.The data were shown by mean±standard, the results were compared by Independent-Samples T Test or one-way analysis of variance between groups and the results before and after surgery were compared by paired T Test.Results(1) The levels of plasma FⅧ:C , FIX:C , vWF:Ag and TpP in patients with pulmonary cancer were significantly higher than healthy controls respectively(FⅧ:C 150.61±50.06% VS 77.4±19.8%,FIX:C 143.45±27.41%VS 102.75±9.61%,vWF 217.74±74.84% VS 140.29±53.54%,TpP 10.14±2.07μg/ml VS 3.58±1.59μg/ml,all P<0.01)(2) The levels of plasma FⅧ:C , FIX:C , vWF:Ag and TpP levels in patients with ovrian cancer were significantly higher than healthy controls respectively (FⅧ:C185.18±90.12 VS 77.4±19.8%, FIX:C 146±40.1 VS 102.75±9.61%,vWF 221.23±109.91 VS140.29±53.54%,TpP 10.1±1.7μg/ml VS3.58±1.59μg/ml,P<0.05)(3) The levels of plasma FⅧ:C , FIX:C , vWF:Ag and TpP in theⅠ～Ⅱstage patients with pulmonaty cancer were significantly higher than healthy controls respectively,(P<0.05). The levels of plasma FⅧ:C, vWF:Ag and TpP in theⅢ～Ⅳstage patients with cancer were significantly higher than theⅠ～Ⅱstage patients with pulmonary cancer respectively,(FⅧ:C 167.52±51.46%VS 118.08±31.6%, vWF 236.91±81.79 % VS 180.89±40.67 % , TpP 11.06±1.67μg/ml VS 8.77±2.3μg/ml, P<0.05).Plasma FIX:C was not significantly differences between tow groups.(4) Four trombosis-related markers were significantly higher among patients with squamous-cell carcinoma, patients with adenocarcinoma and small cell lung cancer than healthy controls,but plasma FⅧ:C﹑FIX:C, TpP levels were not significantly different among three groups.Plasma vWF:Ag was higher significantly in patients with squamous-cell carcinoma than patients with adenocarcinoma , (250.63±95.3 VS195.11±59.76, P<0.05).(5)The levels of plasma FⅧ:C , FIX:C,vWF:Ag and TpP before and after surgery in patients with lung cancer and ovrian cancer are significantly higher than healthy controls respectively ,(P<0.01). Plasma FⅧ:C and FIX:C,TpP levels were significantly higher respectively after surgery in patients with lung cancer and ovrian cancer than before surgery .(FⅧ:C 234.7±64.7%VS 175.5±70.28%,FIX:C 194.4±42.98% VS 158.4±32.64%,TpP 13.31±2.64μg/ml VS 10.21±2.5μg/ml P<0.05). Plasma vWF:Ag was lower after surgery than before surgery. It was not significantly different after surgery and before surgery.Conclusion1. Increasing of plasma FⅧ:C, FIX:C, vWF:Ag and TpP levels in patients with lung cancer and ovrian cancer significantly suggested that these patients were in prethrombotic state and they be proned to thrombosis. It was a certain valuble in assessing prognosis and guide treatment of lung cancer and ovrian cancer.2. Plasma FⅧ:C , vWF:Ag and TpP levels in patients with lung cancer continue to increase with tumor metastasis suggested that lung cancer patients with prethrombotic state is closely related to disease progression. Increasing of plasma FⅧ:C, vWF:Ag and TpP levels in lung cancer patients predicted change in condition and prognosis. They could be as more sensitive indicators which was used to diagnose for prethrombotic state, evaluate progress of the condition , determine prognosis and recommend treatment for lung cancer.3. Lung cancer and ovrian cancer patients were in prethrombotic state after surgery than before surgery further. It suggested that preventive anticoagulant therapy is essential for cancer patients on the seventh day after surgery.