ACQUIRED CANCER-RELATED THROMBOPHILIA TESTIFIED BY INCREASED LEVELS OF PROTHROMBIN FRAGMENT 1 + 2 AND D-DIMER IN PATIENTS AFFECTED BY SOLID TUMORS

Micco P. Di, Lucia D. De, Vita F. De, Niglio A., Micco G. Di, Martinelli E., Chirico G., D’Uva M., Torella R.

Alteration of haemostasis are common during oncological disease and thromboembolic complications have been recognized as one of the most common cause of morbidity and mortality of these patients. This study was designed to identify thrombophilic markers in cancer patients affected by solid tumors, in order to prevent thrombotic events. We studied 52 patients with gastrointestinal and breast cancer (24 males and 28 females, mean age 51 ± 6 years) and 42 health subjects (15 males and 27 females, 49 ± 7 years) as control group. We measured prothrombin time, activated partial thromboplastin time, fibrinogen, vitamin K dependent clotting factors (i.e. II, VII, IX, X), natural clotting inhibitors, activated protein C resistance, prothrombin 1 + 2 fragment and d-dimer in all subjects. We found a significant increase in plasma levels of prothrombin 1 + 2 fragment of cancer patients compared with control subjects and d-dimer plasma levels were increased in 89% of cancer patients compared with control subjects. In conclusion we can assert that cancer patients with solid tumors are at risk for thrombotic event as demonstrated by increased concentrations of prothrombin 1 + 2 fragment and d-dimer. In particular, prothrombin 1 + 2 fragment showed a sensibility better than d-dimer in the identification of cancer-related thrombophilia. However, a screening of these markers of hypercoagulable state could help to prevent a thrombotic event in cancer patients if just interpreted.

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