Changes of hemostatic molecular markers after gynecological surgery

The authors evaluated the hemostatic abnormalities occurring in the postope rative period of eight patients with malignant tumors and compared them wit h those occurring in the postoperative period of eight patients with benign tumors. Two of the patients with malignant tumor presented pulmonary embol ism after operation. Plasma fibrinogen and fibrin degradation product level s in patients with malignant tumors were already high before operation and further increased significantly after operation. The plasma levels of D-dim er, thrombin-antithrombin complex, and free-tissue factor pathway inhibitor were increased in both groups after operation, but they vv ere higher in p atients with malignant tumors than in patients with benign tumors. The plas ma levels of protein C and antithrombin were significantly decreased in bot h groups after operation, but they were significantly lower in patients wit h malignant tumors than in those with benign tumors. The decreased activity of protein C or antithrombin may be not only a risk factor of thrombotic d isease, such as pulmonary embolism, but also the cause of thrombosis. In pa tients with malignant tumors, the operation time was significantly longer t han that in patients with benign tumors. This long operative period might c ause vascular endothelial cell injury which is reflected by the plasma leve ls of free-tissue factor pathway inhibitor, antithrombin, and protein C.