fibrinopeptide-a and Neoplasm-Metastasis

The effect of an immunotherapy with Corynebacterium parvum on the blood coagulation system was investigated in a randomized trial of 18 patients with metastatic breast cancer. All patients received cytostatic therapy. Additionally, C. parvum was given intravenously on day 15 of the cytostatic cycle (group I) or on day 1 (group II) or not at all (group III). Fibrinopeptide A increased within 2 h after intravenous administration of C. parvum in groups I and II and normalized after 24 h (p less than 0.05). Platelet counts decreased continuously in all treatment groups (p less than 0.05). Prothrombin time, fibrinolytic concentration, factor VIII:C and factor VIIIR:Ag were not affected. The fibrinolytic activity showed a slight but not statistically significant increase after intravenous administration of C. parvum. The data suggest that plasma hypercoagulability is induced or enhanced in man even after small intravenous doses of C. parvum.

Topics: Bacterial Vaccines; Blood Coagulation Disorders; Breast Neoplasms; Female; Fibrinopeptide A; Humans; Immunotherapy; Neoplasm Metastasis; Platelet Count; Propionibacterium acnes

This investigation was carried out to evaluate fibrin formation and degradation in various types of solid neoplasms by measuring fibrinopeptide A (fpA) in the plasma with a radioimmunoassay and D-dimer (DD) with an enzyme-linked immunosorbent assay in 176 cancer patients; 77 of them showed signs of distant metastasis (M1). FpA and DD were abnormally elevated in 81 and 143 patients respectively. FpA and DD were significantly correlated and unrelated to plasma fibrinogen. Both fpA and DD levels were more elevated in M1 than M0 patients. Coumarin anticoagulants, administered to 32 patients of our series with the aim of preventing cancer growth and dissemination, caused a significant decrease both in fpA and DD levels. Our data provide evidence of increased in vivo fibrin formation and degradation in solid neoplasms: oral anticoagulants can modulate cancer-related hypercoagulation.

Topics: Adult; Aged; Aged, 80 and over; Coumarins; Enzyme-Linked Immunosorbent Assay; Female; Fibrin; Fibrinopeptide A; Humans; Male; Middle Aged; Neoplasm Metastasis; Neoplasms; Radioimmunoassay

Abnormalities of blood coagulation associated with neoplasia may be important in the pathogenesis of tumour spread. Most patients with advanced malignancy have evidence of activated coagulation, but the mechanisms underlying this are unclear. We have examined in vitro monocyte procoagulant activity and compared this to plasma levels of fibrinopeptide A, in 52 patients with clinically localised breast cancer. Patients with localised breast cancer and activated coagulation displayed a strong positive correlation between monocyte procoagulant activity and level of fibrinopeptide A(r = +0.86, p less than 0.001). No such relationship was demonstrated in a smaller number of patients with metastatic breast cancer. It is concluded that monocyte procoagulant activity plays an important role in coagulation activation in patients with localised breast cancer. The implications of this for adjuvant anticoagulant therapy in breast cancer are discussed.

Topics: Adult; Aged; Aged, 80 and over; Blood Coagulation Factors; Breast Neoplasms; Female; Fibrinopeptide A; Humans; Lymphocyte Activation; Male; Middle Aged; Monocytes; Neoplasm Metastasis

In 70 patients affected by gastrointestinal malignancies the plasma fibrinopeptide A (FpA) levels were assessed both before and at various intervals after the operation. At the same time other more commonly used tests of coagulation were carried out. In all the patients plasma FpA levels were shown to be variously elevated, so that they could give useful clues to the diagnosis, treatment, prognosis and follow-up of the gastrointestinal malignancies. In all the patients the coagulation tests fell into the normal ranges. However in the patients affected by recto-sigmoid adenocarcinoma an increase of circulating fibrin degradation products (FDPs) was observed which paralleled the increase of plasma FpA. In conclusion, in gastrointestinal malignancies the increase of plasma FpA levels suggests the cancer-induced start of the coagulation cascade. The assay of this peptide proves to be a reliable marker for these diseases.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Female; Fibrinogen; Fibrinopeptide A; Gastrointestinal Neoplasms; Humans; Male; Middle Aged; Neoplasm Metastasis; Prognosis

To provide more information on the pathways of fibrinogen catabolism in generalized cancer, the effect of heparin on fibrinopeptide A (fpA) and on 125I-fibrinogen kinetics was studied in 15 patients with disseminated neoplasia. Three patients had evidence of venous thrombosis and in 2 additional patients a low fibrinogen level together with increased amounts of FDP/fdp and a positive ethanol test indicated disseminated intravascular coagulation (DIC). The plasma levels of fpA were grossly elevated (4.6--20, mean 11.4 ng/ml, normal values 1.01 +/- 0.45 ng/ml) in patients with thrombosis or DIC, and normal to grossly elevated (0.4--10.4, mean 6.1 ng/ml) in the other patients. Intravenous heparin bolus lowered the fpA level in 11/11 patients, and continuous heparin treatment led to an impressive suppression or complete normalization of the plasma fpA in 5/6 patients. This finding is thought to reflect heparin suppression of thrombin activity on fibrinogen. In some cases, the fpA fall after heparin bolus was slow and/or incomplete, suggesting fpA generation at sites not easily accessible to heparin or insufficient heparin dosage. The 125I-fibrinogen kinetics were characterized by a significantly shorter half-life (t1/2: 2.5 days), increased catabolic rate constant (j: 0.44 days-1), and increased absolute turnover (68.9 mg fibrinogen/kg/day) as compared to 4 normal subjects (t1/2: 4.2 days; j: 0.26 days-1; turnover 21.7 mg fibrinogen/kg/day). As estimated from the fpA generation rates, intravascular thrombin action on fibrinogen contributed only in minor part to increase the turnover of 125I-fibrinogen. In particular, the turnover was greatly accelerated in heparin-treated patients despite impressive suppression or normalization of the fpA levels in 5/6 cases.

Topics: Adult; Aged; Disseminated Intravascular Coagulation; Female; Fibrin Fibrinogen Degradation Products; Fibrinogen; Fibrinopeptide A; Heparin; Humans; Iodine Radioisotopes; Kinetics; Male; Middle Aged; Neoplasm Metastasis; Neoplasms