Hemostatic Derangements in Patients with Solid Malignant Tumors

Mazin R. Mohammed ； Saad S. Mansoor ； Mustafa Ghany Taher

《Journal of pioneering medical sciences》 3卷1期 (2013/03) Pp. 1-9

並列摘要

BACKGROUND: Cancer patients show an increased susceptibility to thromboembolic diseases. Although clinical symptoms occur less frequently, disorders of coagulation are very common in cancer patients. The aim of the study was to determine the presence of hemostatic derangements in patients suffering from solid malignant tumors. METHODS: This case-controlled study was conducted on patients with solid malignant tumors who presented to Al-Yermok Teaching Hospital and Hospital of Radiation and Nuclear Medicine in Iraq, from January 2004 to July 2004. Forty cases were included in the study and the control group included fifteen age and gender matched healthy volunteers. Platelet count was determined from blood sample, while tests for prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), fibrinogen and D-dimer were conducted on plasma. RESULTS: Fourteen patients had slight concurrent bleeding; only one patient gave history of recurrent attacks of deep venous thrombosis. The most common hemostatic abnormalities were elevated D-dimer (45%, n=18), thrombocytosis (27.5%, n=11), prolonged TT (25%, n=10) and hyperfibrinogenemia (25%, n=10). The mean PT, aPTT and TT were higher in subjects with malignancies as compared to the healthy controls; and these variables were also higher in those with evidence of intravascular coagulation and fibrinolysis (ICF) as compared to those without ICF syndrome. The mean fibrinogen level and platelet count were higher in patients with malignancy (mean=3.1 g/L) and (mean=317.8 x 109/L) as compared to healthy controls (mean=3 g/L and mean=260.7 x 109/L) respectively where the (p=0.02 and p=0.08) respectively; moreover, the mean of platelets tended to be lower when there was evidence of decompensated type ICF (mean=125 x 109/L), rather than compensated type (mean=171.4 x 109/L) or over compensated type (mean=491.4 x 109/L). The rate of occurrence of ICF syndrome was not significantly higher with adenocarcinoma than that with other histologic types (p=0.18). On the other hand, this rate was significantly higher with high grade tumor than with low grade tumor and in patients with distant metastasis (p=0.001). CONCLUSION: Hemostatic derangement is common in patients with a wide variety of malignancies. The plasma D-dimer test with other indices of DIC syndrome forms a good and simple applicable panel of tests for assessment of ICF syndrome.

並列關鍵字

Hemostatic derangement ； Solid malignant tumor ； D-dimer