SIGNIFICANCE OF PLASMA FIBRINOPEPTIDE-A (FPA) IN PATIENTS WITH MALIGNANCY

Abstract

In 124 patients with various types of malignancy, fp[fibrinopeptide]A and .DELTA.fpA were measured. In 35 of these patients the effect of heparin injection on fpA and .DELTA.fpA was studied. All patients were ambulant without clinical signs of venous thromboembolism or DIC [disseminated intravascular coagulation] and had not received cytostatic, anticoagulant or radiotherapy recently. In .apprx. 75% of these patients, fpA was elevated, whereas in the blood of 1/3 of the patients, both elevated fpA levels and accelerated .DELTA.fpA were detected. Of the 45 patients with accelerated .DELTA.fpA (and elevated fpA), 8 presented laboratory signs of low-grade DIC. In the patients taken at random for heparin administration, .DELTA.fpA normalized upon heparin injection, whereas in the majority of patients, irrespective of the fpA-generation rate, fpA levels were not affected by adequate heparinization. About 30% of the (selected) patients admitted to the cancer clinic present with evidence of intravascular thrombin activity and in 70% of these patients fpA is generated, at least in part, at a site not accessible to heparin. In addition, 95% of patients with active metastatic disease showed an elevated fpA, whereas 90% of cancer patients in remission and 80% of patients without metastasis had a normal fpA, indicating that fpA can potentially be used to estimate the spread and the activity of the malignant process.