PMID- 27161678
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160610
LR  - 20160510
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 140 Suppl 1
DP  - 2016 Apr
TI  - OC-06 - Pro-thrombotic biomarkers in pancreatic diseases: are they specific of 
      cancer?
PG  - S170-1
LID - S0049-3848(16)30123-2 [pii]
LID - 10.1016/S0049-3848(16)30123-2 [doi]
AB  - INTRODUCTION: Venous thrombo-embolic events (VTE) occur frequently in patients 
      with pancreatic cancer and contribute to elevated morbidity and mortality. 
      Clinical risk factors for thrombosis such as cancer stage and tumor grade have 
      been clearly identified. Recently, several biomarkers have been proposed which 
      may help identifying cancer patients at high risk of thrombosis. Those biomarkers 
      have been studied in heterogeneous cohorts of patients with different cancer 
      types. AIM: To compare pro-thrombotic biomarkers in pancreatic cancer and in 
      chronic pancreatitis to determine whether these biomarkers are related to cancer 
      or inflammation and to validate their association with thrombotic risk in a 
      pancreatic cancer population. MATERIALS AND METHODS: 45 patients with pancreatic 
      cancer, 49 with intraductal papillary mucinous tumor of the pancreas (IPMN), a 
      precancerous lesion, and 50 with chronic pancreatitis were recruited. Plasma 
      levels of factor VIII, D-dimers, thrombin-antithrombin complexes, soluble 
      p-selectin, tissue factor-dependent procoagulant activity of MP (TF-MP), free 
      Tissue Factor Pathway Inhibitor (TFPI) and extracellular DNA were measured. 
      Thrombin generation triggered by 1pM of TF was evaluated with the Calibrated 
      Automated Thrombogram assay. RESULTS: Levels of factor VIII, D-dimers, TF-MP, 
      TFPI and extracellular DNA were significantly higher in cancer patients compared 
      to IPMN or chronic pancreatitis (Table 1). Patients with metastatic cancer (n=27) 
      presented higher levels of D-dimers (mean+/-sd 1.77+/-1.28 vs 0.80+/-0.96 mug/ml, 
      p=0.004) and MP-TF (54.3+/-53.2 vs 15.8+/-10.4 fM, p=0.02) compared to patients with 
      localized lesions (n=18). Among cancer patients, 42 were followed for a median 
      duration of 187 days (min 21-max 802 days). VTE occurred in 10 (23%) patients. 
      All had metastatic cancer at the time of thrombosis. Only D-dimers were 
      significantly elevated in cancer patients with VTE compared to patients without 
      VTE (median 1.85 vs 0.7 mug/ml, p=0.02). CONCLUSIONS: Elevation of factor VIII, 
      D-dimers, TF-MP, TFPI and extracellular DNA seems to be related to cancer 
      process, not to local or systemic inflammation as these parameters differentiate 
      cancer from chronic pancreatitis. Interestingly, D-dimers and TF-MP are related 
      to the disseminated cancer stage, suggesting that vascular invasion is a 
      prerequisite to the release of TF-MP from the primary tumor into the bloodstream 
      and to coagulation activation. However, only D-dimers are associated with the 
      occurrence of future VTE. We propose that D-dimers could be a useful tool to 
      predict thrombotic events in pancreatic cancer patients. This should be confirmed 
      in a larger population.
CI  - (c) 2016 Elsevier Ltd. All rights reserved.
FAU - Faille, D
AU  - Faille D
AD  - Unite Fonctionnelle d'Hematologie, Hopital Bichat; INSERM U1148; Universite Paris 
      Diderot, Sorbonne Paris Cite
FAU - Ajzenberg, N
AU  - Ajzenberg N
AD  - Unite Fonctionnelle d'Hematologie, Hopital Bichat; INSERM U1148; Universite Paris 
      Diderot, Sorbonne Paris Cite
FAU - de Chaisemartin, L
AU  - de Chaisemartin L
AD  - Unite Fonctionnelle d'Autoimmunite et Hypersensibilite, Hopital Bichat; INSERM, 
      UMR-S 996; Universite Paris-Sud, Chatenay-Malabry.
FAU - Granger, V
AU  - Granger V
AD  - Unite Fonctionnelle d'Autoimmunite et Hypersensibilite, Hopital Bichat; INSERM, 
      UMR-S 996; Universite Paris-Sud, Chatenay-Malabry.
FAU - Chollet-Martin, S
AU  - Chollet-Martin S
AD  - Unite Fonctionnelle d'Autoimmunite et Hypersensibilite, Hopital Bichat; INSERM, 
      UMR-S 996; Universite Paris-Sud, Chatenay-Malabry.
FAU - de Raucourt, E
AU  - de Raucourt E
AD  - Unite Fonctionnelle d'Hematologie, Hopital Beaujon.
FAU - Hammel, P
AU  - Hammel P
AD  - Universite Paris Diderot, Sorbonne Paris Cite; Departement de Pancreatologie, 
      Hopital Beaujon; INSERM U773-CRB3; France.
FAU - Levy, P
AU  - Levy P
AD  - Universite Paris Diderot, Sorbonne Paris Cite; Departement de Pancreatologie, 
      Hopital Beaujon; INSERM U773-CRB3; France.
FAU - Ruszniewski, P
AU  - Ruszniewski P
AD  - Universite Paris Diderot, Sorbonne Paris Cite; Departement de Pancreatologie, 
      Hopital Beaujon; INSERM U773-CRB3; France.
FAU - Rebours, V
AU  - Rebours V
AD  - Universite Paris Diderot, Sorbonne Paris Cite; Departement de Pancreatologie, 
      Hopital Beaujon; INSERM U773-CRB3; France.
LA  - eng
PT  - Journal Article
DEP - 20160408
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
EDAT- 2016/05/11 06:00
MHDA- 2016/05/11 06:01
CRDT- 2016/05/11 06:00
PHST- 2016/05/11 06:00 [entrez]
PHST- 2016/05/11 06:00 [pubmed]
PHST- 2016/05/11 06:01 [medline]
AID - S0049-3848(16)30123-2 [pii]
AID - 10.1016/S0049-3848(16)30123-2 [doi]
PST - ppublish
SO  - Thromb Res. 2016 Apr;140 Suppl 1:S170-1. doi: 10.1016/S0049-3848(16)30123-2. Epub 
      2016 Apr 8.