Prognostic significance of blood coagulation tests in lung cancer

Previous studies have shown that activation of coagulation has an impact on the clinical course of lung cancer. This study was carried out to assess the potential prognostic significance of platelet count (P), prothromhin time (PT), partial thromboplastin time ( PTT), anti-thrombin III (AT-III), fibrinogen (F), D-dimer (DT)), factor II (F-II), factor VII (F-VII), factor X (F-X), protein C clotting (PCC), plasm inogen (PL), and antiplasmin (AP) in 343 consecutive new lung cancer patien ts. A set of 32 anthropometric, clinical, physical, laboratory, radiologica l, and pathological variables was recorded prospectively for all patients. Patients were carefully followed-up, and their subsequent clinical course r ecorded. The most frequent abnormalities were of DD, F, and AT-III followed by F-VII , F-X, and F-II. Among the 12 clotting variables, the strongest relationshi ps were those of F-II and F-X (Spearman rank (r(s))=0.565), PT and F-VII (r (s)=0.562), F-VII and F-X (r(s)=0.514), PL and AP (r(s)=0.515), F and P (r( s)=0.490), AT-III and PCC (r(s)=0.476). Univariate analyses of survival sho wed that prolonged PT (p<0.043), and abnormally elevated DD (p<0.003), F (p <0.031), and P (p<0.047) were all associated with a poor prognosis. The mul tivariate model, however, did not confirm the prognostic significance of th e coagulation factors. The results shaw :subclinical activation of blood coagulation in lung cance r patients with early disease. In addition, clotting activation is confirme d as a predictor of survival, although not independently of other prognosti c factors.