Related Experiment Videos
Clinical significance of "circulating fibrin monomers'
Abstract:
During the decade 1970-9 we investigated circulating fibrin monomers in 3293 patients. Fibrinaemia was determined by means of the ethanol gelation test (EGT). This was positive in 149 patients (4.5%) and was highly correlated with fibrogenal fibrin products. In many diseases the test was only transiently positive (1 or 2 days). However in patients with circulating fibrin monomers, demonstrable for more than 5 days (chronic fibrinaemia) malignant disease was associated in 63%. Chronic fibrinaemia occasionally preceded overt malignancy by a long period. Overall, only 10.8% of patients with malignant disease showed chronic fibrinaemia. The clinical symptoms most often associated with chronic fibrinaemia were those of venous thrombosis (42.8%) and abnormal bleeding (10.7%). Thromboembolism in the absence of malignant disease only occasionally showed short-term positive EGT and chronic fibrinaemia was never seen. Almost half (46.5%) of patients with chronic fibrinaemia had neither thromboembolic disease nor a haemorrhagic diathesis.
Insights
Chronic fibrinaemia, indicated by a positive ethanol gelation test (EGT) for over five days, is strongly linked to malignant disease. This condition can precede cancer diagnosis and is associated with thrombosis and bleeding disorders.
Area of Science:
- Hematology
- Oncology
- Clinical Pathology
Background:
- Circulating fibrin monomers are abnormal protein products found in blood.
- The ethanol gelation test (EGT) is used to detect the presence of fibrin monomers.
Purpose of the Study:
- To investigate the prevalence and clinical significance of circulating fibrin monomers.
- To determine the association between chronic fibrinaemia and malignant disease, thromboembolism, and bleeding disorders.
Main Methods:
- A cohort of 3293 patients was studied over a decade (1970-1979).
- Fibrinaemia was assessed using the ethanol gelation test (EGT).
- Patients were categorized based on the duration of a positive EGT (transient vs. chronic fibrinaemia).
Main Results:
- A positive EGT (fibrinaemia) was observed in 4.5% of patients.
- Chronic fibrinaemia (positive EGT > 5 days) was associated with malignant disease in 63% of cases.
- Chronic fibrinaemia occasionally preceded overt malignancy.
- Venous thrombosis (42.8%) and abnormal bleeding (10.7%) were common clinical symptoms in chronic fibrinaemia.
- Only 10.8% of cancer patients exhibited chronic fibrinaemia.
- Thromboembolism without malignancy rarely showed chronic fibrinaemia.
- Nearly half of patients with chronic fibrinaemia had no thromboembolic or hemorrhagic issues.
Conclusions:
- Chronic fibrinaemia is a significant indicator of underlying malignant disease, sometimes appearing years before diagnosis.
- While associated with thrombosis and bleeding, chronic fibrinaemia can exist independently of these conditions.
- The EGT is a valuable tool for identifying patients at risk for serious underlying pathologies.