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143 The pre- and postoperative levels of tissue type plasminogen activator and von Willebrand factor in plasma of patients with larynx cancer
POSTER PRESENTATIONS P-V Malignant Diseases: Prognostic and Diagnostic Markers
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HAEMOSTASIS IN RENAL CELL CARCINOMA. IZ Zi~tek, 21. Iwan-Zi~tek, 2M. Kotsciw, xZ Wolski, 2F~Wigmiewska,2E. ~!'ekanowska,2R. Pa~zuski, Depmtment oftUrology mad 2Pathophysiology, University Medical School, Bydgoszcz, Poland. In neoplastic diseases thromboembolic and bleeding complications often occur. Tissue factor and plasminogen activators are supposed to be responsible for these phenomena. Cells of renal carcinoma are an important source of tissue factor. Th,~ aim of our work was the estimation of haemostasis in 40 patients (20 men and 20 women in similar age at 60) with renal cell carcinoma (RCC) in stage T1-4, N+/-, M+/- without any symptoms of bleeding or thromboembolic complications. The control group consisted of 30 healthy volunteers in similar age and sex. The following determinations were performed: tissue type plasminogen activator antigen (t-PA:Ag), urokinase type plasminogen activator antigen (uPA:Ag) and activity (uPA:Ac), plasminogen, alpha-2 antiplasmin (alpha-2 AP) activity, plasmin/alpha-2 antiplasmin (PAP) complex, von Willebrand factor antigen (vWF) and antithrombin HI (AT HI) activity. In blood of patients with renal cell carcinoma a higher AT HI activity, vWF and uPA:Ag were observed. Other exmnined parameters were in normal range. We noticed that in the advanced stage of cancer ('1"3-4) vWF and uPA:Ag were significant higher than in the other stages (T1-2). The higher AT HI activity may be a positive factor protecting against thromboembolic complications. Normal value of alpha-2 AP and PAP contradict an increased fibrinolytic activation, vWF and u_PA:Ag can be considered as a prognostic factors of progress ofneopl .astic diseases.
T H R O M B I N - A N T I T H R O M B I N I ! ! C O M P L E X E S C O N C E N T R A T I O N IN BLOOD PLASMA OF WOMEN WITH CERVICAL CARCINOMA TREATE[ WITH IRRADIATION.
3Miododska J., tUszyrlski M., 2Zekanowska E., ~SukowskiJ. tDept, of Propedeutics of Medicine and 2Dept. of Patophysiology, University School of Medicine, 3Regional Centre of Ontology, Bydgoszcz, Poland. Our question was whether the therapeutic irradiation can induce thrombin generation. Thrombin-antithrombinIII complexes (TAT) were measured as markers ofthrombin generation in vivo. The study group consisted of 20 women (average age of 58.8) with diagnosed cervical carcinoma. 9 women with the I° of carcinoma underwent radical histerectomy and then irradiation, while 11 women at a more advanced stage of illness (III° and IV°) were treated only with irradiation (fractionated doses, the therapeutic dose: 4400-11120 cGy). TAT complexes were measured by ELISA method. We found out: 1) Already before treatment TAT level in blood plasma of the patients was higher than in the control group, and was 4.4+4.0 ng/ml and 2.6±0.4 ng/ml respectively (p< 0.04). 2) Only women, who were first operated and then underwent irradiation, showed a temporary, statistically significant increase (at p< 0.05) of TAT concentration (as a rule before absorption of 1000 cGy). With women treated exclusively with irradiation TAT concentration did not change significantly. It was additionally found that TAT level was positively correlated with fibrinogen level (coef. 0.958, p < 0.003), and with activated partial thromboplastin time (coef. 0.755, p< 0.08); the correlation was negative with the number of blood platelets (coef. - 0.849, p < 0.03). Conclusion: Standard therapeutic doses of irradiation cause only transient increase ofthrombin generation as TAT measurements show.
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VON VtrlIJ,F.]~RA_ND FACTOR LEVELS IN PLASMA OF PATIENTS WITH CANCER OF URINARY BLADDER. l_Paczuski R. 2Zi~tek 7_, lIwan-Zi~tek I. lKotschy M. tDepm~ment of Patophysiology and 2Department of Urology, University School of Medical Sciences, Bydgoszcz, Poland.
THE PRE- AND POSTOPERATIVE LEVELS OF TISSUE TYPE PLASMINOGEN ACTIVATOR AND VON vtqIIff,EBRAND FACTOR IN PLASMA OF PATIENTS WITH LARYNX CANCER. tPaczuski P,)Biulkowska A.2Betleiewsld S.2Burduk D)Kotschy M ~Depmlment of Pathophysiology and 2Department of Otolaryngoiogy, University School of Medical Sciences, Bydgoszc~
Von Willebrand factor (vWt) is a multimeric plasma protein synthesised in vascular endothelimn and megacariocytes. In some types of neoplasms elevated concentrations of vWf:A8 are reported but studying literature we found no report on urinary bladder neoplasms. Our study group consisted of 26 patients (17 men and 9 women) aged 37 to 77 (mean 67) years with recognised carcinoma transitionale of urinary bladder. The patients were in non-invnsive T1 NO M0(9) and invasive T3-4 N +/_ M+/- (17) stages of cancer. The levels ofvWf:A8 in plasma were measured with ELISA and compared with results obtained for group of 22 healthy volunteers. Results healthy non-invnsive invasive ©ontrols stage stage M (IU/dl) SD
43
98 19
132 60
230 91
These results indicate that concen~'ations of yon Willebrand factor were significantly increased only for group with invasive stages oftumour (p<0,00001). The differences in levels of vWf between both groups were statistically si~ificant (13<0.01) indicating that the levels of vWf antigen correlated with tmnour stage increasing with advancement of disense.
Tissue type plasminogen activator (tPA) and yon Willebrand factor (vW0 are plasma proteins syntethetized in endothelial cells. Both proteins are markers of endothelial injury. Elevated levels of these proteins are reported in various diseases. The aim of our study was to compare the pre- and postoperative levels oftPA antigen and vWf antigen in plasma of patients with carcinoma planoepitheliae of larynx. The object of the study was a group of 20 men aged 42-75 (mean 55) years. The control group consisted of 22 healthy persons. The blood samples were obtained one day before operation, immediately after, 24 hem's, and 96 hours after operation The preoperative levels of tPA:Ag, and vW~Ag were si~ificantly elevated comparing with controls and reached 10.6 ng/ml, SD 7.37 (I~0.002) and 189 IU/dl, SD 72 (p<0.001) respectively. Results of tPA:Ag recorded for control group xyere 4.6 ag/ml SD 2.45, and of vWf.'Ag 98% SD 19. The levels of both proteins after operation compared with initial values (preoperative = 100%) were following 24h before after I 24h after 96h after tPA 100% 185% I 93% 72% vWf 100% 167% I 156°/° 157°/° Increased levels oftPA:Ag and vWf:Ag in larynx cancer, especially immediately after m-gory indicate on potent injury of vascular endothelium. Despite oftPA normalisation the concentrat.ions ofvWfremalned up to four days on similar high levels.
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HAEMOSTASIS IN RENAL CELL CARCINOMA. IZ Zi~tek, 21. Iwan-Zi~tek, 2M. Kotsciw, xZ Wolski, 2F~Wigmiewska,2E. ~!'ekanowska,2R. Pa~zuski, Depmtment oftUrology mad 2Pathophysiology, University Medical School, Bydgoszcz, Poland. In neoplastic diseases thromboembolic and bleeding complications often occur. Tissue factor and plasminogen activators are supposed to be responsible for these phenomena. Cells of renal carcinoma are an important source of tissue factor. Th,~ aim of our work was the estimation of haemostasis in 40 patients (20 men and 20 women in similar age at 60) with renal cell carcinoma (RCC) in stage T1-4, N+/-, M+/- without any symptoms of bleeding or thromboembolic complications. The control group consisted of 30 healthy volunteers in similar age and sex. The following determinations were performed: tissue type plasminogen activator antigen (t-PA:Ag), urokinase type plasminogen activator antigen (uPA:Ag) and activity (uPA:Ac), plasminogen, alpha-2 antiplasmin (alpha-2 AP) activity, plasmin/alpha-2 antiplasmin (PAP) complex, von Willebrand factor antigen (vWF) and antithrombin HI (AT HI) activity. In blood of patients with renal cell carcinoma a higher AT HI activity, vWF and uPA:Ag were observed. Other exmnined parameters were in normal range. We noticed that in the advanced stage of cancer ('1"3-4) vWF and uPA:Ag were significant higher than in the other stages (T1-2). The higher AT HI activity may be a positive factor protecting against thromboembolic complications. Normal value of alpha-2 AP and PAP contradict an increased fibrinolytic activation, vWF and u_PA:Ag can be considered as a prognostic factors of progress ofneopl .astic diseases.
T H R O M B I N - A N T I T H R O M B I N I ! ! C O M P L E X E S C O N C E N T R A T I O N IN BLOOD PLASMA OF WOMEN WITH CERVICAL CARCINOMA TREATE[ WITH IRRADIATION.
3Miododska J., tUszyrlski M., 2Zekanowska E., ~SukowskiJ. tDept, of Propedeutics of Medicine and 2Dept. of Patophysiology, University School of Medicine, 3Regional Centre of Ontology, Bydgoszcz, Poland. Our question was whether the therapeutic irradiation can induce thrombin generation. Thrombin-antithrombinIII complexes (TAT) were measured as markers ofthrombin generation in vivo. The study group consisted of 20 women (average age of 58.8) with diagnosed cervical carcinoma. 9 women with the I° of carcinoma underwent radical histerectomy and then irradiation, while 11 women at a more advanced stage of illness (III° and IV°) were treated only with irradiation (fractionated doses, the therapeutic dose: 4400-11120 cGy). TAT complexes were measured by ELISA method. We found out: 1) Already before treatment TAT level in blood plasma of the patients was higher than in the control group, and was 4.4+4.0 ng/ml and 2.6±0.4 ng/ml respectively (p< 0.04). 2) Only women, who were first operated and then underwent irradiation, showed a temporary, statistically significant increase (at p< 0.05) of TAT concentration (as a rule before absorption of 1000 cGy). With women treated exclusively with irradiation TAT concentration did not change significantly. It was additionally found that TAT level was positively correlated with fibrinogen level (coef. 0.958, p < 0.003), and with activated partial thromboplastin time (coef. 0.755, p< 0.08); the correlation was negative with the number of blood platelets (coef. - 0.849, p < 0.03). Conclusion: Standard therapeutic doses of irradiation cause only transient increase ofthrombin generation as TAT measurements show.
142
143
VON VtrlIJ,F.]~RA_ND FACTOR LEVELS IN PLASMA OF PATIENTS WITH CANCER OF URINARY BLADDER. l_Paczuski R. 2Zi~tek 7_, lIwan-Zi~tek I. lKotschy M. tDepm~ment of Patophysiology and 2Department of Urology, University School of Medical Sciences, Bydgoszcz, Poland.
THE PRE- AND POSTOPERATIVE LEVELS OF TISSUE TYPE PLASMINOGEN ACTIVATOR AND VON vtqIIff,EBRAND FACTOR IN PLASMA OF PATIENTS WITH LARYNX CANCER. tPaczuski P,)Biulkowska A.2Betleiewsld S.2Burduk D)Kotschy M ~Depmlment of Pathophysiology and 2Department of Otolaryngoiogy, University School of Medical Sciences, Bydgoszc~
Von Willebrand factor (vWt) is a multimeric plasma protein synthesised in vascular endothelimn and megacariocytes. In some types of neoplasms elevated concentrations of vWf:A8 are reported but studying literature we found no report on urinary bladder neoplasms. Our study group consisted of 26 patients (17 men and 9 women) aged 37 to 77 (mean 67) years with recognised carcinoma transitionale of urinary bladder. The patients were in non-invnsive T1 NO M0(9) and invasive T3-4 N +/_ M+/- (17) stages of cancer. The levels ofvWf:A8 in plasma were measured with ELISA and compared with results obtained for group of 22 healthy volunteers. Results healthy non-invnsive invasive ©ontrols stage stage M (IU/dl) SD
43
98 19
132 60
230 91
These results indicate that concen~'ations of yon Willebrand factor were significantly increased only for group with invasive stages oftumour (p<0,00001). The differences in levels of vWf between both groups were statistically si~ificant (13<0.01) indicating that the levels of vWf antigen correlated with tmnour stage increasing with advancement of disense.
Tissue type plasminogen activator (tPA) and yon Willebrand factor (vW0 are plasma proteins syntethetized in endothelial cells. Both proteins are markers of endothelial injury. Elevated levels of these proteins are reported in various diseases. The aim of our study was to compare the pre- and postoperative levels oftPA antigen and vWf antigen in plasma of patients with carcinoma planoepitheliae of larynx. The object of the study was a group of 20 men aged 42-75 (mean 55) years. The control group consisted of 22 healthy persons. The blood samples were obtained one day before operation, immediately after, 24 hem's, and 96 hours after operation The preoperative levels of tPA:Ag, and vW~Ag were si~ificantly elevated comparing with controls and reached 10.6 ng/ml, SD 7.37 (I~0.002) and 189 IU/dl, SD 72 (p<0.001) respectively. Results of tPA:Ag recorded for control group xyere 4.6 ag/ml SD 2.45, and of vWf.'Ag 98% SD 19. The levels of both proteins after operation compared with initial values (preoperative = 100%) were following 24h before after I 24h after 96h after tPA 100% 185% I 93% 72% vWf 100% 167% I 156°/° 157°/° Increased levels oftPA:Ag and vWf:Ag in larynx cancer, especially immediately after m-gory indicate on potent injury of vascular endothelium. Despite oftPA normalisation the concentrat.ions ofvWfremalned up to four days on similar high levels.