The effect of adjuvant chemotherapy on plasma TAT and F 1+2 levels in patients with breast cancer

• Published in: Biomedicine & pharmacotherapy 2015-07, Vol.73, p.19-23
• Main Authors: Topcu, Turkan Ozturk, Kavgacı, Halil, Canyılmaz, Emine, Orem, Asim, Yaman, Huseyin, Us, Diler, Ozdemir, Feyyaz, Aydın, Fazıl
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antithrombin III; Biomarkers, Tumor - blood; Breast cancer; Breast Neoplasms - blood; Breast Neoplasms - diagnosis; Breast Neoplasms - drug therapy; Case-Control Studies; Chemotherapy, Adjuvant - methods; Female; Humans; Internal Medicine; Medical Education; Middle Aged; Peptide Fragments - blood; Peptide Hydrolases - blood; Prothrombin; Prothrombin fragment 1 + 2; Thrombin–antithrombin; Treatment Outcome; Young Adult
• ISSN: 0753-3322; 1950-6007
• DOI: 10.1016/j.biopha.2015.05.003

Abstract Introduction Increased thromboembolic disorders and chemotherapy-induced thromboembolic events are well known phenomena in patients with breast cancer. Antithrombin III (AT III) inactivates thrombin, resulting in increased thrombin–antithrombin (TAT) levels. Activated factor X cleaves prothrombin and thrombin, resulting in increased levels of prothrombin fragment 1 + 2 (F 1 + 2). Increased TAT and F 1 + 2 levels show coagulation activation. The aim of this study was to examine plasma levels of TAT and F 1 + 2 and the effect of anthracycline-based chemotherapy on plasma TAT and F 1 + 2 in patients with operable breast cancer. Materials and methods Seventy patients and 30 age-matched healthy controls were enrolled. Levels of TAT and F 1 + 2 were investigated before and after adjuvant chemotherapy. Basal levels (pre-chemotherapy) of TAT and F 1 + 2 in patients were compared with those in healthy controls and patient levels after 3 cycles of chemotherapy. Levels of TAT and F 1 + 2 were determined using the ELISA method. Results TAT and d -dimer levels were significantly higher in patients, ( P : 0.02 and P < 0.001, respectively). Post-chemotherapy F 1 + 2 levels were higher than basal levels ( P : 0.02). F 1 + 2 levels were higher in patients, although the difference was not statistically significant ( P : 0.52). There was no difference between basal and post-chemotherapy TAT levels. Discussion In conclusion, while higher post-chemotherapy F 1 + 2 levels suggest that the cumulative effect of chemotherapy increases the risk of thrombosis, TAT and d -dimer levels indicate that the effect of the cancer further increases the risk of thrombosis in patients with operable breast cancer.