Abstract
Lupus anticoagulants is related to both recurrent thrombosis and cancer. Thrombotic complications occur more frequently in patients with lung cancer. The aim of this study is to investigate the association of lupus anticoagulants with hypercoagulability and thrombotic complications, as well as prognostic significance of lupus anticoagulants for patients with lung cancer. The study comprised 205 patients with non–small cell lung cancer. Plasma normalized LAC ratio, D-dimer, fibrinogen, activities of antithrombin, and FVIII before treatment were analyzed by coagulation analyzer, and routine hematologic and biochemical parameters were also evaluated. In patients, normalized LAC ratio, D-dimer, fibrinogen, and procoagulant activity of coagulating factor VIII levels significantly increased, whereas antithrombin activity significantly decreased compared with healthy controls (P < .001). Normalized LAC ratio was positively correlated with D-dimer, fibrinogen, and procoagulant activity of coagulating factor VIII, and negatively correlated with antithrombin activity, respectively (P < .01). D-dimer, procoagulant activity of coagulating factor VIII, and antithrombin levels revealed statistical difference in non–deep venous thrombosis patients with elevated or normal normalized LA ratio (P < .05). The incidence of deep venous thrombosis and tumor metastasis was higher, and 1-year survival rate was lower in elevated normalized LAC ratio patients than in normal ones, respectively (P < .01). There was higher normalized LAC ratio level in patients with deep venous thrombosis and/or metastasis (P < .05). In 1-year deceased patients, normalized LAC ratio level and the incidence of deep venous thrombosis and metastasis were higher than those in survivors, respectively (P < .05). Hazard regression analysis demonstrated normalized LAC ratio was independently associated with short survival time in patients with non–small cell lung cancer (hazard regression: 2.871, 95%confidence interval: 1.704-4.835; χ2: 19.130; P < .01). Our study suggests that lupus anticoagulants is a useful marker to predict thrombotic complications and prognosis in patient with lung cancer.
Highlights
Antiphospholipid antibodies (APA) constitute a diverse group of autoantibodies reacting with phospholipids antigens
The results indicated that patients with hypercoagulable state may be at greater risk in developing thrombotic complications than those without such disorders
We found that normalized LAC ratio (NLR) was markedly elevated in patients with non–small cell lung cancer (NSCLC), while prothrombin time (PT) and activated partial thromboplstin time (aPTT) did not reveal statistical difference between the 2 groups, which could be explained by what the prolongating effect of LA on aPTT compensated by coagulating factors activation in some patients
Summary
Antiphospholipid antibodies (APA) constitute a diverse group of autoantibodies reacting with phospholipids antigens. Antiphospholipid antibodies may be associated with a variety of diseases such as systemic lupus erythematosus (SLE), other autoimmune disorders, connective tissue disorders, malignancies, drug use, and infections or with no underlying disease.[1,2] As a major APA, lupus anticoagulants (LAC) can increase in many diseases such as SLE, malignancies, infections, and so on.[3,4] the actual mechanisms have not been fully elucidated. Lupus anticoagulants may increase the risk for thrombosis in patients without SLE and is defined as the risk factor for recurrent arterial and venous thromboembolism.[5,6]. Patients with lung cancer would have higher morbidity and mortality
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