The influences of selected clotting and fibrinolysis factors on survival of patients with kidney tumors - a prospective study.

Introduction: Multiple studies suggest that cancer leads to activation of clotting and fibrinolysis pathways, elevating the risk of thromboembolic events. Kidney cancer is often complicated by clotting disorders. In this study, we hypothesized that preoperative clotting and fibrinolysis parameters are altered in healthy volunteers and kidney tumor patients. We also hypothesized that these differences may be associated with survival in patients who have undergone operations due to kidney tumors. Material and methods: In this study, 96 patients with kidney tumors and 30 healthy volunteers were recruited at a single university center. All patients were assessed for pre-operative serum concentrations of tissue factor (TF), tissue factor pathway inhibitor (TFPI, total TFPI, full-length TFPI, truncated TFPI), plasmin-antiplasmin complex (PAP), thrombin-antithrombin complex (TAT), von Willebrand factor (vWF), clotting factor XIII A1 (FXIIIA1), D-dimers, and fibrinogen. Additionally, standard peripheral blood morphology was evaluated. Results: Malignant kidney tumors were diagnosed in 85 of 96 tumor patients. In patients with kidney tumors, there were statistically significantly higher concentrations of fibrinogen, D-dimers, TAT, PAF, TF, TFPI, vWF, FXIIIA1, and leukocyte counts compared to the control group. Statistically significant correlations were found between multiple parameters. This points to significant clotting system alterations. Cox stepwise hazard analysis showed that pre-operative fibrinogen and D-Dimer concentrations were significantly associated with survival. Conclusions: In patients with kidney tumors, multiple clotting and fibrinolysis parameters are significantly altered. Routine pre-operative measures should include determination of fibrinogen and D-dimer concentrations as these markers aid in prediction of survival probability.

Receptor GP IIb/IIIa as an Indicator of Risk in Vascular Events.

Type 2 diabetes causes a significant risk of cardiovascular diseases, leading to 70% of deaths in patients with diabetes. The effective treatment of diabetes significantly reduces the risk of requiring the involvement of specialists from various fields of medicine. This research aimed to assess the risk of cardiovascular events based on selected biochemical parameters (glycoprotein [GP] IIb/IIIa, von Willebrand factor [vWf], fibrinogen) and their changes in response to physical exercise. The research group consisted of 52 patients with type 2 diabetes with micro- or macro-angiopathy at a mean age of 63.80 years (8.79). The control group consisted of 50 healthy volunteers (17 women and 33 men) at a mean age of 51.16 years (6.39). All the patients consented to have their venous blood tested to measure complete blood counts. Activated GP IIb/IIIa receptors were labeled and analyzed by flow cytometry. Mean values of vWF factor were higher when compared with the control group (196.59% [80.32%] vs 148.06% [90.34%], respectively). The GP IIb/IIIa receptor expression was much higher in test patients than in the control group (3.91% [2.91%] vs 2.79% [2.51%]). Physical exercise had a positive influence on GP IIb/IIIa receptor expression and vWF, decreasing their baseline percentage values.