Correlation between tumor necrosis factor-alpha and d-dimer levels in non-small cell lung cancer patients

Abstract

The present study was designed to investigate whether a correlation exists between IL-6, TNF-α and coagulation (Thrombin–antithrombin, TATc) or fibrinolysis ( d-dimer) activation in non-small cell lung cancer (NSCLC) patients. One hundred thirty patients with NSCLC ( n=65, 53 males, mean age 65±8, adenocarcinoma n=32, squamous cancer n=33) or chronic obstructive pulmonary disease (COPD) ( n=65, 51 males, mean age 67±9) were studied. As control group 65 healthy donors (51 males, mean age 61±14) were also evaluated. The results obtained showed that median d-dimer levels were higher in NSCLC patients (3.0 μg/ml) compared either to COPD patients (1.1 μg/ml, P<0.05) or controls (0.3 μg/ml, P<0.0001). Positive TNF-α levels (>10 pg/ml) were found in 26% of NSCLC compared to 3% of COPD ( P<0.002) and 5% of controls ( P<0.0005). On the other hand, positive (>8.5 pg/ml) IL-6 levels were found in 53% of NSCLC and 21% of COPD patients, compared to 5% of control subjects ( P<0.001). Median TATc levels were elevated in either NSCLC (6.9 μg/l) or COPD (5.7 μg/l) patients compared to controls (1.8 μg/l, P<0.0001). Elevated d-dimer levels were significantly associated to positive TNF-α levels in patients without distant metastasis ( F=4.3, P<0.05). Moreover, TNF-α levels ( P<0.01) were independently related to the presence of positive d-dimer levels in patients with non-metastatic NSCLC. These results suggest that increased levels of TNF-α might be responsible for an activation of fibrinolysis in patients with NSCLC.