Clinical Significance of Preoperative Thrombin Time in Patients with Esophageal Squamous Cell Carcinoma following Surgical Resection

Background Noninvasive tools for the prognosis of ESCC are urgently needed. To this end, serum coagulation tests have been researched in some cancers, but the prognostic value of the TT in ESCC has not been described. Methods The levels of pre-treatment serum coagulation markers (including the PT, APTT, PTA, INR, fibrinogen level, TT and PLT) were retrospectively analyzed in 204 patients with ESCC who underwent surgical resection at our department and in 200 healthy controls, and the two groups were compared. The prognostic significance of the coagulation tests was then determined with univariate and multivariate cox hazard analyses in patients with ESCC. Results Compared with those in normal controls, the PT, APTT, and fibrinogen levels were significantly increased, whereas the TT values significantly decreased in the 204 ESCC patients. The TT directly correlated with the 5-year survival rate, not only in the entire ESCC cohort (p = 0.023) but also in the subgroups stratified according to the T and N classifications and metastasis. Conversely, the other tests were not independent prognostic factors for ESCC. Of the clotting markers, the TT inversely correlated with the fibrinogen level (p = 0.005). Conclusions The 5-year survival was shorter in ESCC patients exhibiting decreased pre-treatment TT values. Thus, the serum TT may be a clinical prognostic factor for ESCC patients.

[1]  Wei Sun,et al.  Clinical and Prognostic Significance of Coagulation Assays in Pancreatic Cancer Patients With Absence of Venous Thromboembolism , 2015, American journal of clinical oncology.

[2]  M. Samama,et al.  The Thrombophilic State in Cancer Patients , 2001, Acta Haematologica.

[3]  P. Mannucci,et al.  Hypercoagulability and hyperfibrinolysis in patients with melanoma. , 1996, Thrombosis research.

[4]  F. Tas,et al.  Clinical and prognostic significance of coagulation assays in lung cancer. , 2013, Respiratory medicine.

[5]  T. Omori,et al.  Clinical significance of plasma fibrinogen level as a predictive marker for postoperative recurrence of esophageal squamous cell carcinoma in patients receiving neoadjuvant treatment. , 2014, Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus.

[6]  M. De Cicco.  The prothrombotic state in cancer: pathogenic mechanisms. , 2004, Critical reviews in oncology/hematology.

[7]  L. Leichman,et al.  Paclitaxel given by a weekly 1-h infusion in advanced esophageal cancer. , 2007, Annals of oncology : official journal of the European Society for Medical Oncology.

[8]  F. Rosendaal,et al.  Malignancies, prothrombotic mutations, and the risk of venous thrombosis. , 2005, JAMA.

[9]  H. Matsubara,et al.  Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma. , 2004, Journal of the American College of Surgeons.

[10]  A. Jemal,et al.  Global cancer statistics , 2011, CA: a cancer journal for clinicians.

[11]  L. Hefler,et al.  Plasma fibrinogen levels in patients with benign and malignant ovarian tumors. , 2015, Gynecologic oncology.

[12]  Peter D Siersema,et al.  Esophageal cancer. , 2008, Gastroenterology clinics of North America.

[13]  J. Staško,et al.  D-dimer, plasminogen activator inhibitor-1, prothrombin fragments and protein C - role in prothrombotic state of colorectal cancer. , 2011, Neoplasma.

[14]  A. Falanga,et al.  Clotting mechanisms and cancer: implications in thrombus formation and tumor progression. , 2003, Clinical advances in hematology & oncology : H&O.

[15]  R. Bick.  Coagulation Abnormalities in Malignancy: A Review , 1992, Seminars in thrombosis and hemostasis.

[16]  A. Falanga,et al.  Pathophysiology of the Thrombophilic State in the Cancer Patient , 1999, Seminars in thrombosis and hemostasis.

[17]  Shaker A Mousa,et al.  The role of tissue factor pathway inhibitor in tumor growth and metastasis. , 2007, Seminars in thrombosis and hemostasis.

[18]  P. Thodiyil,et al.  Variation in Relative Risk of Venous Thromboembolism in Different Cancers , 2002, Thrombosis and Haemostasis.

[19]  S. Hao,et al.  Platelets and fibrinogen facilitate each other in protecting tumor cells from natural killer cytotoxicity , 2009, Cancer science.

[20]  L. Ke.  Mortality and incidence trends from esophagus cancer in selected geographic areas of China circa 1970–90 , 2002, International journal of cancer.

[21]  R. Fisher,et al.  Thromboembolism in hospitalized neutropenic cancer patients. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[22]  S. Goodnight.  BLEEDING AND INTRAVASCULAR CLOTTING IN MALIGNANCY: A REVIEW , 1974, Annals of the New York Academy of Sciences.

[23]  Dai,et al.  Platelet activation. , 2020, Arteriosclerosis.

[24]  P. V. van Dam,et al.  Plasma fibrin D-dimer levels correlate with tumour volume, progression rate and survival in patients with metastatic breast cancer , 2002, British Journal of Cancer.

[25]  O. Hoffmann,et al.  Perioperative development of a thrombogenic risk profile in patients with carcinomas of the breast: a cause of increased thrombosis. , 2000, European journal of gynaecological oncology.

[26]  A. Falanga,et al.  Pathogenesis of Thrombosis in Patients with Malignancy , 2001, International journal of hematology.

[27]  A. Falanga,et al.  Molecular basis for the relationship between thrombosis and cancer. , 2001, Thrombosis research.

[28]  U. Langsenlehner,et al.  The association of an elevated plasma fibrinogen level with cancer-specific and overall survival in prostate cancer patients , 2015, World Journal of Urology.

[29]  L. Ginaldi,et al.  Coagulation and cancer: Implications for diagnosis and management , 2010, Pathology & Oncology Research.

[30]  Q. Song,et al.  The clinical significance of preoperative plasma fibrinogen level and platelet count in resectable esophageal squamous cell carcinoma , 2015, World Journal of Surgical Oncology.

[31]  M. Oya,et al.  High preoperative plasma D-dimer level is associated with advanced tumor stage and short survival after curative resection in patients with colorectal cancer. , 2001, Japanese journal of clinical oncology.

[32]  L. Iversen,et al.  Relationship of Coagulation Test Abnormalities to Tumour Burden and Postoperative DVT in Resected Colorectal Cancer , 2002, Thrombosis and Haemostasis.

[33]  F. Langer.  [Haemostatic aspects in clinical oncology]. , 2015, Hamostaseologie.

[34]  C. Francis,et al.  Impact of venous thromboembolism and anticoagulation on cancer and cancer survival. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[35]  H. Weng,et al.  Clinical and prognostic significance of preoperative plasma hyperfibrinogenemia in gallbladder cancer patients following surgical resection: a retrospective and in vitro study , 2014, BMC Cancer.

[36]  F. Rickles,et al.  Activation of blood coagulation in cancer: Trousseau's syndrome revisited. , 1983, Blood.