DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20185369

Haemostatic abnormalities in solid malignancies

Supriya D. Joshi, Hemant G. Murdeshwar, Gopal A. Pandit

Abstract


Background: Though the actual symptoms of any haemostatic abnormalities in patients of solid malignancies are not seen commonly screening in all such cases can guide us to correct those abnormalities in time and improve the outcome. The present study is undertaken with an objective to find out coagulation disorders in patients of solid malignancies and compare their levels according to the stage of the cancer.

Methods: A prospective study was undertaken in a tertiary care centre in Maharashtra, India from December 2010 to September 2012. Total 102 cases with malignancies diagnosed on histopathology/cytological examination were tested for BT, CT, Platelet count, PT, APTT, TT and D-dimer levels. These tests were repeated on first postoperative or post chemotherapy day wherever possible. Early and advanced stages of cancer were divided according to the spread of the tumor. Results were compared between the two. DIC cases were also noted.

Results: Out of 102 cases studied, haemostatic abnormalities were more common in adenocarcinomas that too in mucin secreting adenocarcinomas. The percentage of cases with increased D-dimer values was higher in the advanced disease compared to early disease. The PT, APTT, TT and platelet count showed statistically significant differences between the early and advanced disease groups. Compared to preoperative values, postoperative values were abnormal but the change was not statistically significant.

Conclusions: Screening for coagulation profile in all solid malignancies can help to predict the chances of complication and therapeutic interventions can be done.


Keywords


D-dimer, DIC, Haemostatic, Malignancy

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References


Trousseau A. Phlegmasia alba dolens. In: Lectures on clinical medicine. Hotel-Dieu, Paris, P. Victor Bazire byTrousseau, Armand, 1801-1867; 1865:654-712.

Varki A. Trousseau’s syndrome: multiple definitions and multiple mechanisms. Blood. 2007;110(6):1723-9.

Enshaei A, Moradi A, Mikaili P, Rezaei S. Correlation of preoperative level of D-dimer with pathological staging of colorectal cancers. Am J Sci Res. 2012;(52):5-12.

Komurcuoglu B, Ulusoy B, Gayaf M, Guler A, Ozden E. Prognostic value of plasma D-dimer levels in lung carcinoma. Tumori. 2011;97(6):743-8.

Karagöz B, Alacacioğlu A, Bilgi O, Demirci H, Ozgün A, Alev Akyol Erikçi, et al. Platelet count and platelet distribution width increase in Lung cancer patients. Anatol J Clin Investing. 2009:3(1):32-4.

Guo X, Chen M, Ding L, Zhao S, Wang Y, Kang Y, Liu Y. Application of cox model in coagulation function in patients with primary liver cancer. AJOSG. 2011;58(106):326-30.

Kies MS, Posch JJ, Gioma JP, Rubin RN. Hemostatic function in cancer patients. Cancer. 1980;46:831-7.

Turna H, Ozguroglu M, Bolayirli M, Orhanoglu T, Balci H. Is there any effect of tumor burden on hemostatic parameters in cancer patients? a case-control study of hemostatic abnormalities and anticardiolipin antibodies in solid tumors. Clin Appl Thromb Hemost. 2009;15:454.

Ujjan ID, Khokhar NA, Shaikh MA, Shaikh IA, Memon RA, Maheshwari N. Evaluation of coagulation abnormalities in lung cancer patients. JLUMHS. 2009;8(2):118-20.

Kovacova E, Kinova S, Duris I, Remcova A. General changes in hemostasis in gastric cancer. Bratisl Lek Listy. 2009;110(4):215-21.

Inal S, Tasci C, Karadurmas N, Kuzhan O, Balkan A, Ozkan M, et al. The association of D-dimer levels with other prognostic factors in patients with lung cancer. Turk J Med Sci. 2008;38(3):209-17.

Suega K, Bakta IM. Correlation between clinical stage of solid tumor and D dimer as a marker of coagulation activation. Acta Med Indones. 2011 Jul;43(3):162-7.

Taguchi O, Gabazza EC, Yasui H, Kobayashi T, Yoshida M, Kobayashi H. Prognostic significance of plasma D-dimer levels in patients with lung cancer. Thorax. 1997;52(6):563-5.

Sitalakshmi S, Rameshkumar K, Damodar P. Significance of haemostatic markers in ovarian carcinoma. Ind J Med Paedia Oncol. 2008;29(2):6-10.

Sun NC, McAfee WM, Hum GJ, Weiner JM. Hemostatic abnormalities in malignancy, a prospective study of one hundred eight patients. Part I. Coagulation studies. Am J Clin Pathol. 1979;71(1):10-6.

Sallah S. Wan JY, Nguyen NP, Hanrahan LR, Sigounas G. Disseminated intravascular coagulation in solid tumors: clinical and pathologic study. Thrombosis and hemostasis. 2001;86(3):828-33.

Kirwan CC, McDowell G, McCollum CN, Kumar S, Byrne GJ. Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer. Brit J Cancer. 2008;99:1000-6.

Wang HY, Zhao QY, Yuan YF. Perioperative changes of coagulation functions in the local advanced liver cancer patients receiving liver transplantation. Chin J Cancer. 2008 Jul;27(7):65-9.

Xu C, Fu X. The changes of blood coagulation in surgical patients with lung cancer. Zhongguo Fei Ai Za Zhi. 2010;13(2):136-9.

Gang Xu, Ya-Li Zang, Wen Huang. Relationship between plasma D-dimer levels and clinicopathologic parameters in resectable colorectal cancer patients. World J Gastroenterol. 2004;10(6):922-3.