An increased tendency for blood to clot promotes the progression and metastasis of lung cancer. Whether or not blood coagulation also promotes the development of tumors was previously unknown. Researchers at the German Cancer Research Center (In German: Deutsches Krebsforschungszentrum, DKFZ) are for the first time investigating a possible role of blood coagulation in the development of lung cancer.
In the prospective EPIC-Heidelberg study, scientists investigated whether pre-diagnostic markers of blood coagulation could be used to predict the risk of lung cancer. They determined the number of different factors involved in blood clotting, such as fibrinogen, soluble glycoproteins, soluble P-selectin and others.
These characteristic proteins of blood coagulation were determined in baseline blood samples from 2,480 EPIC participants. The coagulation factor concentrations of 190 EPIC participants with lung cancer during the follow-up period of the EPIC study were then compared with these baseline values.
"Both a higher blood concentration of fibrinogen and soluble P-selectin well before the onset of the disease were significantly associated with a higher risk of lung cancer in our work," first author Mirja Grafetstätter describes the main result of the study: "This is the first indication that an increased coagulation activity not only promotes an already existing lung cancer but could also be involved in its development. However, a causal link still has to be tested in further studies."
“With the current study, we supported the hypothesis for the first time that an increased blood coagulation tendency could promote the development of lung cancer,'' said Tilman Kühn, head of the study. The clearest correlation between cancer risk and blood coagulation is therefore for two proteins of the blood coagulation cascade, fibrinogen, and soluble P-selectin. Whether the concentrations of both proteins might be used as a pre-diagnostic marker for the individual risk of lung cancer in the future can only be decided after the current results have been reviewed in independent studies.
Mirja Grafetstätter, Anika Häusing, Sandra Gonzalez Maldonado, Disorn Sookthai, Theron Johnson, Laura Pletsch-Borba, Verena A. Katzke, Michael Hoffmeister, Peter Bugert, Rudolf Kaaks, and Tilman Kühn: Plasma Fibrinogen and sP-Selectin are Associated with the Risk of Lung Cancer in a Prospective Study.
Cancer Epidemiol Biomarkers Prev. 2019, DOI: 10.1158/1055-9965.EPI-18-1285