Published in Cancer Detection and Prevention 1995; 19(4):331-336.
Usefulness of Coagulation Markers in Staging of Gastric CanceraInstitute of Medical Pathology, Univ of Ferrara, Italy; b Dept of Medicine and Oncology Clinic, St. Anna Hospital, Ferrara, Italy; cLaboratory of Radioimmunology of Nuclear Medicine, St. Anna Hospital, Ferrara, Italy; and dInstitute of Chirurgia Generale, Univ of Ferrara, Italy
Address all correspondence and reprint requests to: Vincenzo Abbasciano, M.D., Istituto di Patologia Medica, Universita di Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy
ABSTRACT: Thirty-six patients with nonmucinous adenocarcinoma of the stomach, candidates for surgical laparotomy, were studied to evaluate the presence and extent of coagulation disorders in gastric cancer. They were staged according to TNM cancer staging (T: extent of primary tumor; N: lymph node involvement; M: presence of metastases), and a blood sample was collected before surgery. Platelets, platelet factor four (PF4), beta- thromboglobulin (BTG), activated partial thromboplastine time (APTT), prothrombin time (PT), factors five (V) and seven (VII), fibrinogen, cross-linked fibrin degradation products (XDP), fibrinopeptide-A (Fp-A), and antithrombin three (AT 111) were assayed. Only fibrinogen, Fp-A, PF4, and factors V and VII were increased in more than 50% of patients. Fibrinogen and Fp-A were positively correlated with T (r = 0.29, p < p < 0.05, and r = 0.35, p < 0.05; respectively), whereas the other parameters did not show any statistically significant relationship with T, N, and M. Considering the subgroups including only the patients with pathological values, Fp-A (31 patients) was positively correlated with N (r 0.4, p < 0.05). PF4 (25 patients) showed a positive correlation with T and N (r = 0.42, p < 0.05; r 0.46, p < 0.05. respectively), and a significantly higher median in the presence than in the absence of metastases (median in the M+ subgroup: 42.7 ng/ml, range 38.6 to 102.8; median in the M- subgroup: 33.7, range 20.3 to 85; p < 0.01). Our results suggest that the coagulation tests routinely employed often do not reveal any coagulation impairment in gastric cancer, and less simple but more sensitive tests may be necessary to show underlying coagulation disorders. The usefulness of coagulation tests in staging patients with gastric cancer is questionable; only Fp-A and PF4 seem to have some value.