1978 Volume 9 Issue 2 Pages 233-237
Patients with malignant disease are often complicated by bleeding or thrombosis. In recent years, altered blood coagulation and fibrinolytic system in malignancy has been reported by many investigators. In this study, the changes of coagulation and fibrinolytic system in patient with malignant tumors were followed up during and after operation.
Material and method: The series consisted of twenty-three patients in the following diagnostic categories: malignant lymphoma (1); carcinoma of the stomach (10), breast (5), large intestine (3) and pancreas (1); and cholelithiasis (3). Plasma fibrinogen, plasminogen, α1-antitrypsin, α2-macroglobulin and antithrombin III were determined by single radial immunodiffusion method. Fibrin and fibrinogen degradation product in serum was determined by hemaggultination inhibition titer. Platelets were counted by automatic counter.
Result and Discussion: The patients were divided in three groups; the first group (15 cases) was malignant disease with laparotomy, the second group (5 cases) was malignant desease without laparotomy and the third group (3 cases) was non-malignant disease. In many cases with tumors, plasma fibrinogen levels were elevated pre-operatively. It was observed that the concentration of fibrinogen was decreased during the first post-operative day and greatly increased until one or two weeks after operation. In most cases, the number of platelets was decreased for a few days and thereafter it was increased over the pre-operative value in two weeks after operation. The elevated concentration of FDP in serum was found in three of the twenty patients with tumors pre-operatively. After operation, serum FDP was elevated for two or three weeks in most cases of malignancy and especially in the cases of inoperable tumors, the elevated concentrations of FDP and fibrinogen were found at third week after operation.
The concentrations of plasminogen, α2-macroglobulin and antithrombin III were decreased during operation and returned to pre-operative value until to seven days after operation. Although individual variations were observed pre-operatively, α1-antitrypsin concentrations in patients with tumors were increased during and after operation and returned to pre-operative value in about third week post-operatively.
From these data, it is suggested that cancer patients have a delicately balanced coagulofibrinolytic system and its disorder may be induced by surgical treatment.
