D-dimer and international normalized ratio (INR) are correlated with tumor markers and disease stage in colorectal cancer patients

Cancer Biomark. 2015;15(4):405-11. doi: 10.3233/CBM-150477.

Abstract

Background: The aim of this study is to evaluate the correlation of coagulation tests with various clinicopathological variables and tumor markers among colorectal cancer (CRC) patients.

Materials and methods: Ninety-four CRC patients were included for evaluation of clinicopathological factors, coagulation assays and tumor marker levels.

Results: Metastatic disease was related with elevated INR (p= 0.03). Stage III patients had higher D-dimer values compared with stage II patients (p= 0.03). Correlation of tumor markers indicated a tendency towards elevated D-dimer levels for CEA values higher than median (p= 0.01). High CA 19-9 levels were also associated with higher INR (p= 0.007). Elderly age, distant metastasis, high CEA, CA-19-9 and LDH levels were associated with poorer overall-survival. CEA level was the only independent prognostic factor in multivariate analysis.

Conclusions: Coagulation assays can be utilized as predictors of disease extent in CRC. Elevated D-dimer and INR values may indicate higher disease stage. Correlation of D-dimer levels with CEA supports their value for assessing tumor burden.

Keywords: CA 19-9; CEA; D-dimer; Tumor marker; coagulation; colon cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood*
  • Blood Coagulation / genetics
  • CA-19-9 Antigen / blood*
  • Carcinoembryonic Antigen / blood*
  • Colorectal Neoplasms / blood*
  • Colorectal Neoplasms / pathology
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism*
  • Humans
  • International Normalized Ratio
  • L-Lactate Dehydrogenase / blood
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis

Substances

  • Biomarkers, Tumor
  • CA-19-9 Antigen
  • Carcinoembryonic Antigen
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D
  • L-Lactate Dehydrogenase