MARKERS OF PROCOAGULANT IMBALANCE IN PATIENTS WITH LOCALIZED MELANOMAS AND AUTOIMMUNE DISORDERS

Hypercoagulability can be defined as a condition of procoagulant imbal ance due to heightened enzymatic activation of coagulation zymogens, b ut with no laboratory evidence of fibrin deposition nor clinical signs of thrombosis. The imbalance can be detected by measuring the plasma levels of prothrombin fragment 1 + 2 (F1 + 2), fibrinopeptide A (FPA) and thrombin-antithrombin III (TAT) complexes. The aims of this study were to establish the frequency of existence and biochemical pattern o f hypercoagulability in patients with cancer and autoimmune disorders, clinical conditions associated with an increased risk of thrombosis, and to ascertain the most sensitive method for its diagnosis. In appro ximately one-fourth of the patients hypercoagulability was identified by finding high levels of FPA F1 + 2 or TAT unaccompanied by signs of fibrin deposition (expressed by normal levels of D-dimer). In a smalle r proportion of patients (approximately 10%), the concomitant presence of high levels of D-dimer indicated that the activation of the coagul ation cascade had gone beyond the stage of heightened enzymatic activi ty to the point of cross-linked fibrin deposition. Of the markers used to detect hypercoagulability, FPA seems to be the most sensitive, bei ng significantly increased in all clinical conditions studied.