FIBRIN AND FIBRINOGEN DEGRADATION PRODUCTS IN PLASMA OF PATIENTS WITHCOLORECTAL ADENOCARCINOMA

PURPOSE: The aim of the present study was to correlate the preoperativ e plasma levels of TDP in patients with colorectal cancer to tumor sta ge: metastasis, and postoperative thromboembolic complications. METHOD S: Ninety-one patients with colorectal cancer, 20 patients with colore ctal adenoma, and 71 patients without neoplastic lesions in the colon or rectum were included in this prospective study. Before surgery, tot al fibrin and fibrinogen degradation products (TDP) were measured in p lasma of all patients with a specific enzyme-linked immunosorbent assa y test. Phlebography was performed postoperatively in 82 of 91 patient s with colorectal cancer. RESULTS: Median TDP in plasma of patients wi th colorectal cancer (805 (range, 339-5,024) ng fibrinogen equivalents (ngFE)) was significantly higher than TDP in patients with colorectal adenoma (591 (range, 417-1386) ngFE/ml) and TDP in patients without n eoplastic lesions in the colon (632.8 (range, 180-2622) ngFE/ml; P les s than or equal to 0.003). In patients with colorectal cancer and live r metastasis, TDP in plasma (1085.5 (range, 468-5024) ngFE/ml) was sig nificantly higher than in patients with localized tumor growth (753 (r ange, (339-2,780) ngFE/ml; P less than or equal to 0.02). Twenty of 82 patients (24 percent) with cancer developed thromboembolic complicati ons. TDP was preoperatively significantly higher in this group of pati ents (1,101 (range, 468-2,167) ngFE/ml) compared with patients without thromboembolic complications (753 (range, 339-5024) ngFE/ml; P less t han or equal to 0.04). CONCLUSION: Preoperative plasma levels of TDP w ere elevated in patients with colorectal cancer, especially in patient s with liver metastasis and in patients developing postoperative deep venous thrombosis.