Prognostic significance of blood coagulation tests in lung cancer

<jats:p>Previous studies have shown that activation of coagulation has an impact on the clinical course of lung cancer.</jats:p><jats:p>This study was carried out to assess the potential prognostic significance of platelet count (P), prothrombin time (PT), partial thromboplastin time (PTT), anti-thrombin III (AT-III), fibrinogen (F), D-dimer (DD), factor II (F-II), factor VII (F-VII), factor X (F-X), protein C clotting (PCC), plasminogen (PL), and antiplasmin (AP) in 343 consecutive new lung cancer patients. A set of 32 anthropometric, clinical, physical, laboratory, radiological, and pathological variables was recorded prospectively for all patients. Patients were carefully followed-up, and their subsequent clinical course recorded.</jats:p><jats:p>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 relationships were those of F-II and F-X (Spearman rank (r<jats:sub>s</jats:sub>)=0.565), PT and F-VII (r<jats:sub>s</jats:sub>=0.562), F-VII and F-X (r<jats:sub>s</jats:sub>=0.514), PL and AP (r<jats:sub>s</jats:sub>=0.515), F and P (r<jats:sub>s</jats:sub>=0.490), AT-III and PCC (r<jats:sub>s</jats:sub>=0.476). Univariate analyses of survival showed 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 multivariate model, however, did not confirm the prognostic significance of the coagulation factors.</jats:p><jats:p>The results show subclinical activation of blood coagulation in lung cancer patients with early disease. In addition, clotting activation is confirmed as a predictor of survival, although not independently of other prognostic factors.</jats:p>