MESUREMENT OF FIBRINOGEN DEGENERATIVE PRODUCT (FDP) AS A USEFUL EXAMINATION TO SCREEN PATIENTS WHO MIGHT HAVE BONE AND/OR BONE MARROW METASTASIS FROM GASTRIC CANCER

Abstract

Bone and/or bone marrow metastasis (BBM) from gastric cancer is rare, but closely related to disseminated intravascular coagulation (DIC) syndrome.To detect the patients who might have BBM, serum FDP value was routinely measured in 641 patients with advanced gastric cancer from 1984 to 1988 at National Cancer Center Hospital.Eleven patients with high level (≥20μg/ml) received bone marrow aspilation cytology and/or bone scintigram. Of these, 4 patients (36.4%) revealed to have BBM. These 4 patients received anti-cancer chemotherapy and ant-DIC therapy instead of surgery, nevertheless they died of DIC within one or two months.In the group with higher PDP levels, the patients tended to have a more invasive type of cancer with deeper invasion, a larger tumor, more extended lymph node matastasis, more advanced stage and more poorly differentiated cancer.The five-year survival rate for the patients with FDP<10 μg/ml (47.0%) was significantly higher than those for the patients with 10≤FDP<20 (11.0%) and FDP≥0 (0.0%) (p<0.001).These data suggest that the FDP value is one of the definitive prognostic factors for the patients with advanced gastric cancer and is useful for screening the patients with BBM.