fibrin and Genital-Neoplasms--Female

The relationship between tumor stage and the concentration of circulating heparin achieved after subcutaneous administration and its effect on fibrin generation were studied in 24 women with gynecologic malignancy. A single subcutaneous injection of 5000, 7500, and 10,000/U of sodium heparin was given in random order on different days. Plasma specimens for antithrombin III, fibrinopeptide A, and heparin were obtained serially over an 11-hour interval. Women with a Stage III or IV malignancy had significantly lower circulating heparin after the 5000 and 10,000/U doses. There was a significant decline in fibrinopeptide A as the concentration of circulating heparin increased. Thirty-three percent of women with a Stage III or IV malignancy had no detectable circulating heparin at any point examined over the 11 hours after 5000/U of heparin. Likewise, 16.7% and 8.4% had no detectable circulating heparin after 7500 and 10,000/U, respectively. A similar percentage was noted in a smaller group of women with Stage II malignancy. Next, a known quantity of heparin was added to the plasma from these patients and the concentration of heparin was determined. A significant amount of heparin-neutralizing activity was documented. We conclude that a large percentage of women with an advanced gynecologic malignancy are able to neutralize heparin administered for the prevention of thromboembolic disease. This heparin-neutralizing activity may account for the failure of low-dose heparin to prevent thromboembolic complications in this patient population.

Topics: Antithrombin III; Female; Fibrin; Fibrinopeptide A; Genital Neoplasms, Female; Heparin; Humans; Thromboembolism

The role of angiogenesis in the development of neoplasia has been identified and characterized. However, antiangiogenic therapeutic intervention still requires more evidence to become recognized and successful. The aim of this study was to evaluate levels of selected proangiogenic factors, such as fibrinogen, vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in serum of patients with the gynecologic cancer on the first, third and sixth day of antibiotic therapy, routinely administered as a perioperative treatment. In addition, serum concentrations of gamma-gamma dimers and alpha-polymers of cross-linked fibrin structure and the degree of bFGF binding with the fibrin network were investigated. Immunohistochemistry staining of the excised tumor tissue was also performed. We observed higher levels of bFGF, VEGF, as well as fibrinogen in patients with gynecologic malignancy, as compared to healthy women. In cancer patients, the concentration of alpha-polymers and gamma-gamma dimers of fibrin network increased. Further only gamma-gamma dimers fraction of fibrin was found to bind to bFGF. Immunohistochemical analysis indicated the presence of bFGF in an excised tumor tissue. In conclusion, the decrease of proangiogenic bFGF and fibrinogen levels in a clinical trial of gynecologic patients may confirm anti-angiogenic properties of selected antibiotic therapy.

Topics: Aged; Anti-Bacterial Agents; Biomarkers; Blotting, Western; Female; Fibrin; Fibrinogen; Fibroblast Growth Factor 2; Genital Neoplasms, Female; Humans; Immunoenzyme Techniques; Middle Aged; Neovascularization, Pathologic; Vascular Endothelial Growth Factor A

An increased fibrin level enhances the activity of proangiogenic factors and may contribute to tumor formation. Formation of new blood vessels during angiogenesis leads to neoplasm development through interaction with factors such as basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and interleukins. The aim of this study was to investigate the influence of perioperative antibiotic therapy in women with benign gynecological tumors with regard to basic fibroblast growth factor level, fibrinogen concentration and fibrin viscosity. The influence of clindamycin plus metronidazole therapy (group I) and cephazolin therapy (group II) on fibrinogen concentration, level of bFGF and fibrin viscosity was studied in women diagnosed with nonmalignant myomas and cysts. In patients with benign gynecologic tumors, higher bFGF levels (51.40 +/- 13.72 pg/ml), fibrinogen concentration (348.26 +/- 164.74 mg/dl) and fibrin viscosity (2.63 +/- 0.36 mPa) were observed, as compared with healthy women. There were strong indications that antiangiogenic activity occurred with both clindamycin plus metronidazole and cephazolin, although the response to these particular antibiotic therapies was different. The use of various drug therapies in groups I and II resulted in faster and delayed antiangiogenic effects, respectively. Further research is essential to provide more detailed information about the mechanisms of the induction of antiangiogenic activity by perioperative adjuvant antibiotic treatment.

Topics: Adult; Aged; Angiogenic Proteins; Anti-Bacterial Agents; Cefazolin; Cysts; Female; Fibrin; Fibrinogen; Fibroblast Growth Factor 2; Genital Neoplasms, Female; Humans; Interleukins; Metronidazole; Middle Aged; Myoma; Vascular Endothelial Growth Factor A; Viscosity; Young Adult

D dimer and related crosslinked fibrin derivatives were measured in plasma of normal subjects and in patients with various disorders. In 23 healthy, young females low plasma levels were found (mean 47 ng/ml). In 12 patients with deep vein thrombosis, moderately elevated levels (mean 593 ng/ml) were seen. Higher levels were found in 6 patients with pulmonary embolism (mean 3,337 ng/ml). The highest values occurred in 4 patients with severe intravascular coagulation (31,000 to 390,000 ng/ml). In 22 patients with ovarian cancer and in 21 patients with other gynecologic carcinoma, normal to highly elevated levels of D dimer like material were found. These values corresponded well to concentrations of tumor marker CA 125, measured in the same samples, and to tumor activities staged in these patients based on clinical examinations. Very high values of crosslinked fibrin derivatives (75,000-525,000 ng/ml) were determined in ascitic fluid of patients with ovarian cancer.

Topics: Adult; Antibodies, Monoclonal; Ascites; Enzyme-Linked Immunosorbent Assay; Female; Fibrin; Fibrin Fibrinogen Degradation Products; Genital Neoplasms, Female; Humans; Latex Fixation Tests; Ovarian Neoplasms; Reference Values

Topics: Antigens, Neoplasm; Ascitic Fluid; Female; Fibrin; Genital Neoplasms, Female; Humans; Pleural Effusion

Topics: Chromatography, Affinity; Disseminated Intravascular Coagulation; Female; Fibrin; Fibrinogen; Genital Neoplasms, Female; Humans; Myocardial Infarction; Solubility

During gynecological operations 45 ligamenta infundibulopelvica were resected after 5 to 45 minutes. The intravascular changes of the ligated vasa ovarica were examinated. The histological examinations of the stumps showed, that the organism protects itself by formation of obstruction thrombi against a hemorrhage. The blood coagulation processes are local limited and the endothelial damages are causal important for the obstruction and obliteration.. 30 women, aged 36-55 years, wereooperated on by laparotomy for adnex or ovarian tumors, indicated by Uterus myomatosus. During these operations, 45 ligamenta infundibulopelvica were resected after 5-45 minutes. Histological examinations of the ligated vasa ovarica showed that the organism protects itself by forming obstruction thrombi against a hemorrhage. Blood coagulation processes were locally limited. Endothelial damages are causally important for the development of these obstruction thrombi and their obliteration of the ligated ends. But the obliteration can take place without the formation of thrombi. The endothelial destruction caused by the ligation is sufficient to guarantee the formation of connective tissues which will close off the stump.

Topics: Adult; Blood Coagulation; Blood Vessels; Female; Fibrin; Genital Neoplasms, Female; Hemostasis; Humans; Hysterectomy; Ligation; Middle Aged; Ovary; Platelet Aggregation

Topics: Adenocarcinoma; Adenoma; Adrenal Gland Neoplasms; Breast Diseases; Breast Neoplasms; Female; Fibrin; Fluorescent Antibody Technique; Genital Neoplasms, Female; Hodgkin Disease; Humans; Lymph Nodes; Lymphatic Diseases; Melanoma; Methods; Neoplasms; Neoplasms, Nerve Tissue; Ovarian Neoplasms; Sarcoma; Stomach Neoplasms; Thyroid Neoplasms; Tuberculosis

Topics: Aminocaproates; Antifibrinolytic Agents; Aprotinin; Culture Techniques; Decidua; Endometrium; Female; Fibrin; Fibrinolysis; Genital Diseases, Female; Genital Neoplasms, Female; Hemorrhage; Humans; Methods; Placenta; Pregnancy; Thrombelastography; Uterine Cervical Neoplasms; Uterine Neoplasms; Uterus