Platelet activation and fibrinolysis in large bowel cancer

Four coagulation indices [fibrinopeptide A (FpA), X degradation products (XDPs), platelet factor (PF4), beta-thromboglobulin (beta-TG)] were assessed in 38 patients affected by large bowel cancer at different stages before surgery, 7 and 30 days after it, to evaluate the capacity of such neoplasia to influence coagulation. The reported study showed that (1) FpA levels were elevated in nearly all cases both before and after surgery (thus it is a useful index for the diagnosis of such neoplasia, although its levels are not influenced by the presence of metastases), (2) increased levels of XDPs were found in a significantly (p < 0.05) higher percent of patients 7 days after surgery (no significant differences were observed in relation to the cancer stage), (3) PF4 levels were in the normal range throughout the study, and (4) beta-TG levels were increased throughout the study in a high percentage of cases. It may be inferred that large bowel cancers may affect coagulation in either way(s), by triggering platelet activation and/or fibrinolysis. The most useful index for the diagnosis and follow-up of this neoplasia is FpA, although its levels are unaffected by the presence of metastases. The comprehensive evaluation of the four above-mentioned coagulation indices may give rise to the suspicion of large bowel cancer.