Relationship between circulating tumor cells and coagulation factors in primary lung cancer patients

Objective To investigate the relationship between the presence of circulating tumor cells (CTC) and the values of coagulation factors including D-dimer (D-D), fibrinogen (FIB) and platelet (PLT) in primary lung cancer patients. Methods Peripheral venous blood samples were collected from 79 patients with previously untreated primary lung cancer. The levels of D-D, FIB and PLT were detected. The CTCs were enriched by negative immunomagnetic separation with anti-CD45 antibody and then detected by immunocytochemistry with Anti-pan Cytokeratin antibody. The relationship between these parameters and clinicopathologic characteristics of the patients was analyzed. Results The levels of D-D, FIB and PLT were( 1.74±2.04) mg/L, (3.51±1.46 )g/L, (311±139)×109/L, respectively. The level of D-D was associated with distant metastasis of lung cancer (P=0.046). The level of FIB was associated with clinical stage and distant metastasis (P<0.05). The level of PLT was associated with age, clinical stage and distant metastasis (all P<0.05). Among the 79 patients, there were 45 CTC-positive and 34 CTC-negative cases. The levels of D-D in the CTC-positive and CTC-negative groups were (2.31±2.41)mg/L and (0.99±1.02)mg/L, those of FIB were (3.79±1.56)g/L and (3.14±1.25)g/L, and those of PLT were (338±130)×109/L and (229±129)×109/L, respectively(P<0.05 for all). The positive rate of CTC was significantly higher in the metastasis group (82.8%), significantly higher than that in the non-metastatic group (42.0%, P<0.001). The levels of D-D, FIB and PLT in the metastasis group were (2.33±1.95)mg/L, (4.13±1.43)g/L and (433±74)×109/L, but were (1.40±2.03) mg/L, (3.15±1.37)g/L and (206±88)×109/L in the non-metastatic group (P<0.05 for all). Conclusions The detection of circulating tumor cells may facilitate early prediction of distant metastasis of lung cancer. The hypercoagulation state is more-likely correlated with the distant metastasis of lung cancer. Key words: Lung neoplasms; Circulating tumor cells; D-dimer; Fibrinogen; Blood platelets; Metastasis