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DOI: 10.1055/s-0038-1647446
Plasma Fibrinolytic Profile in Patients with Brain Tumors
Publikationsverlauf
Received 05. März 1990
Accepted after revision 21. August 1990
Publikationsdatum:
02. Juli 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035024/199101/lookinside/thumbnails/10-1055-s-0038-1647446-1.jpg)
Summary
Changes in the fibrinolytic and coagulation values measured preoperatively in brain tumor patients have not been done systematically using individual rather than global assays. Such measurments can provide meaningful information on the status of tumor-host interactions and could potentially help in predicting thromboembolic and hemorrhagic tendencies.
A complete fibrinolytic profile including total fibrinolytic activity (TFA), tissue plasminogen activator (t-PA), plasmin inhibitor (PI), plasminogen activator inhibitor (PAI), protein C (PC) and plasminogen (PLG) was obtained preoperatively in 114 brain tumor patients.
PLG and PI did not show much variation among the groups. TEA was slightly reduced (15%) in patients with malignant brain tumors. t-PA, however, was abnormally low in several patients and in almost 40% of patients with brain metastasis. PAI was above the upper limit of normal in approximately 50% of the patients but particularly in glioma, glioblastoma and metastasis patients. Finally, mean PC was abnormally increased in the glioblastoma and metastasis groups (p <0.001). This is the first study that has measured protein C in brain tumor patients.
In conclusion, plasma fibrinolytic levels show marked changes in a substantial number of brain tumor patients prior to surgery - suggesting an ongoing tumor-host interaction.
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References
- 1 Sawaya R, Highsmith R. Brain tumors and the fibrinolytic enzyme system. In: Advances in Neuro-Oncology Futura Publishing Company, Inc; Mount Kisco, NY: 1988: 103-157
- 2 Weick JK. Intravascular coagulation in cancer. Semin Oncol 1978; 5: 203-211
- 3 Morozov VV. The coagulative and anticoagulative blood systems in cerebral tumors of a supratentorial localization. Zh Nevropatol Psikhiatr im S S Korsakova 1968; 68: 505-509
- 4 Morozov VV. Blood coagulation properties in patients with supratentorial tumors during pre- and postoperative periods. Vopr Neirokhir 1970; 34: 56-60
- 5 Burgman GP, Kachkov IA. Vial’tseva Shcherbakova G G. The state of blood coagulation in patients with glial tumors of the brain. Zh Vopr Neirokhir 1979; 3: 34-39
- 6 Scharrer I, Hubner H. Studies of fibrinolysis in patients with metastasizing malignomas and in patients with non-metastasizing cerebral tumors. Verh Dtsch Ges Inn Med 1977; 83: 1144-1148
- 7 Sawaya R, Highsmith R. Plasminogen activator activity and molecular weight patterns in human brain tumors. J Neurosurg 1988; 68: 73-79
- 8 Sawaya R, Zuccarello M, Highsmith R. Alpha-l-antitrypsin in human brain tumors. J Neurosurg 1987; 67: 258-262
- 9 Sawaya R, Zuccarello M, El-Kalliny M. Brain tumors and thromboembolism: clinical, hemostatic, and biochemical correlations. J Neurosurg 1989; 70: 314A (Abstract)
- 10 Haverkate F, Brakman P. Fibrin plate assay. In: Progress in Chemical Fibrinolysis and Thrombolysis, vol. 1 Davidson JF, Samama MM, Desnoyes PC. (eds). Raven Press; New York: 1975: 151-156
- 11 Friberger P, Knos M, Gustavsson S, Aurell L, Claeson G. Methods for the determination of plasmin, antiplasmin and plasminogen by means of substrate S-2251. Haemostasis 1978; 7: 138-145
- 12 Glas-Greenwalt P. In: Fibrinolysis and the Central Nervous System Sawaya R. (ed). Hanley & Belfus; Philadelphia, PA: 1990: 33-61
- 13 Mancini G, Carbonara AO, Heremans JF. Immunochemical quantitation of antigens by single radial immunodiffusion.. Immunochemistry 1965; 2: 235-254
- 14 Kluft C. Studies on the fibrinolytic system in human plasma: quantitative determination of plasminogen activators and proactivators. Thromb Haemostas 1979; 41: 365-383
- 15 Glas-Greenwalt P, Kant KS, Allen C, Poliak VE. Fibrinolysis in health and disease: severe abnormalities in systemic lupus erythematosus. J Lab Clin Med 1984; 104: 962-976
- 16 Glas-Greenwalt P, Hall JM, Panke TW, Kant KS, Allen CM, Poliak VE. Fibrinolysis in health and disease: abnormal levels of plasminogen activator, plasminogen activator inhibitor, and protein C in thrombotic thrombocytopenic purpura. J Lab Clin Med 1986; 108: 415-422
- 17 Laurell C-B. Quantitative estimation of proteins by electrophoresis in agarose gel containing antibodies. Anal Biochem 1966; 15: 45-52
- 18 Owen Jr CA, Bowie EJ W. Surgical hemostasis. J Neurosurg 1979; 51: 137-146
- 19 Van Der Sande JJ, Veltkamp JJ, Bouwhuis-Hoogerwerf ML. Hemostasis and intracranial surgery. J Neurosurgery 1983; 58: 693-698
- 20 Rehemtulla A, Murphy P, Dobson M, Hart DA. Purification and partial characterization of a plasminogen activator inhibitor from the human glioblastoma, U 138. Biochem Cell Biol 1988; 66: 1270-1277
- 21 Wilson EL, Becker LB, Hoal EG, Dowdle EB. Molecular species of plasminogen activators secreted by normal and neoplastic human cells. Cancer Res 1980; 40: 933-938
- 22 Takada A, Takada Y. Physiology of plasminogen: with special reference to activation and degradation. Haemostasis 1988; 18 (Suppl. 01) 25-35
- 23 Kluft C, Verheijen JH, Jie AF T, Rijken DC, Preston FE, Sue-Ling HM, Jespersen H, Aasen AO. The postoperative fibrinolytic shutdown: a rapidly reverting acute phase pattern for the fast-acting inhibitor of tissue-type plasminogen activator after trauma. Scand J Clin Lab Invest 1985; 45: 605-610
- 24 Kruithof EK O. Plasminogen activator inhibitors - a review. Enzyme 1988; 40: 113-121
- 25 Juhan-Vague I, Moerman B, De Cock F, Aillaud MF, Collen D. Plasma levels of a specific inhibitor of tissue-type plasminogen activator (and urokinase) in normal and pathological conditions. Thromb Res 1985; 33: 523-530
- 26 Sloan IG, Firkin BG. Impaired fibrinolysis in patients with thrombotic or haemostatic defects. Thromb Res 1989; 55: 559-567
- 27 D’Angelo A, Kluft C, Verheijen JH, Rijken DC, Mozzi E, Mannucci PM. Fibrinolytic shutdown after surgery: impairment of the balance between tissue-type plasminogen activator and its specific inhibitor. Eur J Clin Invest 1985; 15: 308-312
- 28 Paramo JA, Alfaro MJ, Rocha E. Postoperative changes in the plasmatic levels of tissue-type plasminogen activator and its fast-acting inhibitor-relationship to deep vein thrombosis and influence of prophylaxis. Thromb Haemostas 1985; 54: 713-716
- 29 Housholder GT. The role of protein C in congenital and acquired thrombotic disorders. J Oral Maxillofac Surg 1988; 46: 781-787
- 30 Griffin JH, Evatt B, Zimmerman TS, Kleiss AJ, Wideman C. Deficiency of protein C in congenital thrombotic disease. J Clin Invest 1981; 68: 1370-1373