Correlación de las alteraciones de la coagulación con el pronóstico en pacientes con cáncer colorrectal

Resum

BACKGROUND: Recently we have seen the importance of coagulation factors are not just for predicting thromboembolic events, but considering that the tumor disease, its stage and even the prognosis may be associated with alterations of these factors. MATERIAL AND METHODS: We conducted a descriptive, analytical, transversal and retrospective work about a group of 45 patients diagnosed and treated for colorectal cancer in years 2009 and 2010. During follow-up we took a blood sample and the group was divided between cases and controls according to present or not recurrence and/or metastatic disease, at the time of the extraction. We studied: Cephalin Time, Fibrinogen, Antithrombin III, Protein C, Protein S, DDimer, Tissue Factor, Factor II, TFPI, TAT, Factor VII, Factor X, t-PA and PAI-1. RESULTS: The group consists of 15 women (32%) and 30 men (64%), with a mean age of 68.2 years (SD: 11.8). Of all coagulation parameters studied, only the fibrinogen showed statistically significant differences (p <0.05) between groups. Altered data were observed in relation to tumor group Cephalin Time, Antithrombin III, Protein C, Protein S, Factor VII, TAT, TFPI, Factor X, t-PA and PAI-1. D-Dimer and Tissue Factor were altered equally in both groups with respect to normal. Factor VII was decreased in the tumor group with a difference close to statistical significance. CONCLUSIONS: In early stages of tumor recurrence or metastasis, coagulation factors are not useful for follow-up, except fibrinogen, which rises in the early stages and even with normal tumor markers. We consider the elevation of fibrinogen in the analytical monitoring of a patient with colorectal carcinoma as an alarm signal.