Author(s): Kaberee Bhuyan Medhi1, Arabinda Das2, Rashmi Rekha Goswami3
Cancer can cause activation of coagulation in many ways and there is definite evidence of abnormalities in haemostatic mechanism which is seen by the presence of one or more circulating markers of haemostatic activation & this is found to be potentiated by the release of tissue factors or procoagulants from normal tissue destructions during tumour development.
• To evaluate the range of different types of haemostatic abnormalities in haematological and epithelial malignancies, especially the head and neck epithelial malignancies.
• To look for the differences in the grades of these abnormalities in metastatic & non-metastatic malignancies.
• To understand the prognostic value of routine tests of coagulation while predicting the outcome of the patient.
MATERIALS AND METHODS
The study was conducted in the Department of Pathology, Gauhati Medical College & Hospital, Guwahati from July 2004 to June 2005. 70 cases comprising of head and neck epithelial malignancies, leukaemias and lymphomas without clinical presentation of haemorrhage or thrombosis were selected and coagulation profiles were seen.
RESULTS AND OBSERVATION
Out of 70 cases of both sexes & different age groups prior to therapeutic intervention, metastatic cases were 22, non-metastatic cases were 29, and 19 cases belonged to leukaemias and lymphomas. The commonest age group affected was 51–60 yrs. and male: female was 3.7: 1. The most frequent abnormality was 41 cases (58.57%) of FDP positivity in the serum followed by 36 cases (51.43%) of hyperfibrinogenaemia; 32 cases (45.71%) shortened bleeding time, etc.
Activated coagulation in cancer leads to increased fibrin deposition stimulated by the destroyed tissues; increased FDPs being a strong marker of coagulation and fibrinolytic activation; increased platelet aggregation by the micro vesicles shed by tumour cells; prolonged PT & APTT being well known markers for disseminated intravascular coagulation(DIC). The abnormalities were more pronounced in the metastatic cases.
We can conclude that various haemostatic abnormalities explaining the disturbed haemostatic-fibrinolytic balance are frequently associated with malignant diseases giving an impetus for development of various researches, prophylactic and therapeutic approaches.