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

The present study was designed to investigate whether a correlation exists between IL-6, TNF-alpha 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 mug/ml) compared either to COPD patients (1.1 mug/ml, P < 0.05) or controls (0.3 mug/ml, P < 0.0001). Positive TNF-alpha 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 mug/l) or COPD (5.7 mug/l) patients compared to controls (1.8 mug/l, P < 0.0001). Elevated D-dimer levels were significantly associated to positive TNF-a levels in patients without distant metastasis (F = 4.3, P < 0.05). Moreover, TNF-alpha 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-a might be responsible for an activation of fibrinolysis in patients with NSCLC. (C) 2003 Elsevier Ireland Ltd. All rights reserved.