[Clinical significance of fibrinopeptide A in surgery]

Plasma Fibrinopeptide A (FPA) and beta-thromboglobulin (beta-TG) were measured in patients with various thrombogenic diseases. Plasma FPA levels were also measured in patients with malignant neoplasm and in patients who had open heart surgery. The following results were obtained. Measurement of FPA using Bentonite absorption method was simple and sensitive for clinical application. Plasma FPA and beta-TG levels were elevated in various thrombogenic diseases. Plasma FPA level correlated neither with plasma beta-TG level nor with plasma fibrinogen level. Measurement of FPA is a useful tool in the diagnosis of thromboembolic diseases, and is more trustworthy when combined with beta-TG measurement. Diagnosis of thromboembolism may be made when FPA levels are over 5 ng/ml or beta-TG over 50 ng/ml. Diagnosis of venous thrombosis was possible by the assay of FPA with a sensitivity of 100 per cent. Diagnosis of arterial thrombosis was made by the assay of beta-TG with a sensitivity of 64 per cent. In patients with gastric cancer, levels of plasma FPA tended to correlate with the size of the tumor, indicating that the progression and the activity of the tumor may be estimated by plasma FPA levels. The mean FPA level at the late stage of cardiopulmonary bypass was 14.2 +/- 6.8 ng/ml, indicating that fibrinogen is consumed during the bypass despite the systemic heparinization.