Changes of the Coagulation and Fibrinolysis System in Malignancy: Their possible Impact on Future Diagnostic and Therapeutic Procedures
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Wolfgang Korte
Abstract
The interaction between malignant cell growth and the coagulation and fibrinolysis system has been a well known phenomenon for decades. During recent years, this area of research has received new attention. Experimental data suggest a role for the coagulation and fibrinolysis system in tumor development, progression and metastasis. Also, clinical research suggests that targeting the coagulation system or fibrinolysis system might influence the course of malignant disease beneficially. This paper reviews data on various hemostatic and fibrinolytic parameters in malignancy; the possible use of such parameters as risk markers in oncology patients; and possible targets of anti-neoplastic therapies using anticoagulant and/or antifibrinolytic strategies. Current evidence suggests that the tissue factor/factor VIIa pathway mediates the most abundant procoagulant stimulus in malignancy via the increase in thrombin generation. Tissue factor has been suggested to mediate pro-metastatic properties via coagulation-dependent and coagulation-independent pathways; tissue factor has also been implicated in tumor neo-angiogenesis. However, so far no model has been validated that would allow the use of tissue factor in its soluble or insoluble form as a marker for risk stratification in tumor patients. On the other hand, there is now good evidence that parts of the fibrinolytic system, such as urokinase-type plasminogen activator and its receptor (“uPAR”), can be used as strong predictors of outcome in several types of cancer, specifically breast cancer. Observation of various treatment options in patients with thomboembolic disease and cancer as well as attempts to use anticoagulants and/or therapies modulating the fibrinolytic system as anti-neoplastic treatment strategies have yielded exciting results. These data indicate that anticoagulant therapy, and specifically low molecular weight heparin therapy, is likely to have anti-neoplastic effects; and that their use in addition to chemotherapy will probably improve outcome of tumor treatment in certain types of cancer. However, the body of clinical data is still relatively small and the question whether or not we should routinely consider the coagulation and/or fibrinolysis system as therapeutic targets in cancer patients is yet to be answered.
Copyright © 2000 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- Changes of the Coagulation and Fibrinolysis System in Malignancy: Their possible Impact on Future Diagnostic and Therapeutic Procedures
- Laboratory Support of the Clinical Nutrition Service
- A new Method for Fast Haptoglobin Phenotyping and Hemoglobin Binding Capacity Calculation Based on Capillary Zone Electrophoresis
- Apolipoprotein E Polymorphism and Serum Concentration in Alzheimer's Disease in Nine European Centres: the ApoEurope Study
- Association of the Apolipoprotein B Gene Polymorphisms with Cholesterol Levels and Response to Fluvastatin in Brazilian Individuals with High Risk for Coronary Heart Disease
- Antioxidant Status, Erythrocyte Membrane Lipid Peroxidation and Osmotic Fragility in Malignant Lymphoma Patients
- Determination of H+/K+-ATPase Activity in Human Gastric Biopsy Specimens
- European Cerebrospinal Fluid Consensus Group a TeamRoom (Lotus Notes)-Based Communication Network
- Automated Enzymatic Mitochondrial Antibody Assay for the Diagnosis of Primary Biliary Cirrhosis
- Study of IgM Aggregation in Serum of Patients with Macroglobulinemia
- Trace Element Reference Values in Serum Determined by Inductively Coupled Plasma Atomic Emission Spectrometry
- Comparison of Two Different Methods for Measurement of Phenylalanine in Dried Blood Spots
- Anti-β2-Glycoprotein I ELISA: Methodology, Determination of Cut-off Values in 434 Healthy Caucasians and Evaluation of Monoclonal Antibodies as Possible International Standards
- Comparative Multicentre Study of a Panel of Thyroid Tests Using Different Automated Immunoassay Platforms and Specimens at High Risk of Antibody Interference
- A G5569A HFE Gene Polymorphism that Interferes in DNA Tests for Genetic Haemochromatosis: Who Needs to Be Re-tested?
- Evaluation of the Conformity of Human Growth Hormone. Concentrations Measured with the DPC Immulite® and the Nichols® Advantage™ Assays
- Atlas of Atherosclerosis – Progression and Regression. By Herbert C. Stary
- Liver Disease and Laboratory Medicine. By Ian McFarlane, Adrian Bomford and Roy Sherwood
Articles in the same Issue
- Changes of the Coagulation and Fibrinolysis System in Malignancy: Their possible Impact on Future Diagnostic and Therapeutic Procedures
- Laboratory Support of the Clinical Nutrition Service
- A new Method for Fast Haptoglobin Phenotyping and Hemoglobin Binding Capacity Calculation Based on Capillary Zone Electrophoresis
- Apolipoprotein E Polymorphism and Serum Concentration in Alzheimer's Disease in Nine European Centres: the ApoEurope Study
- Association of the Apolipoprotein B Gene Polymorphisms with Cholesterol Levels and Response to Fluvastatin in Brazilian Individuals with High Risk for Coronary Heart Disease
- Antioxidant Status, Erythrocyte Membrane Lipid Peroxidation and Osmotic Fragility in Malignant Lymphoma Patients
- Determination of H+/K+-ATPase Activity in Human Gastric Biopsy Specimens
- European Cerebrospinal Fluid Consensus Group a TeamRoom (Lotus Notes)-Based Communication Network
- Automated Enzymatic Mitochondrial Antibody Assay for the Diagnosis of Primary Biliary Cirrhosis
- Study of IgM Aggregation in Serum of Patients with Macroglobulinemia
- Trace Element Reference Values in Serum Determined by Inductively Coupled Plasma Atomic Emission Spectrometry
- Comparison of Two Different Methods for Measurement of Phenylalanine in Dried Blood Spots
- Anti-β2-Glycoprotein I ELISA: Methodology, Determination of Cut-off Values in 434 Healthy Caucasians and Evaluation of Monoclonal Antibodies as Possible International Standards
- Comparative Multicentre Study of a Panel of Thyroid Tests Using Different Automated Immunoassay Platforms and Specimens at High Risk of Antibody Interference
- A G5569A HFE Gene Polymorphism that Interferes in DNA Tests for Genetic Haemochromatosis: Who Needs to Be Re-tested?
- Evaluation of the Conformity of Human Growth Hormone. Concentrations Measured with the DPC Immulite® and the Nichols® Advantage™ Assays
- Atlas of Atherosclerosis – Progression and Regression. By Herbert C. Stary
- Liver Disease and Laboratory Medicine. By Ian McFarlane, Adrian Bomford and Roy Sherwood
