1. Monday,
January 23,
2023
1
Thromboses and nodal
invasion in gastric cancer
PROFESSOR DR. HIWA OMER AHMED
GENERAL AND BARIATRIC SURGERY
University of Sulaimani-College of Medicine
Kurdistan-Iraq
2. Monday,
January 23,
2023
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Gastric cancer is a major global health problem.
Worldwide, gastric cancer is the fifth most
prevalent cancer, and presents with the fourth
highest mortality rate
Lymph node metastasis is one of the most
important influencing factors for poor prognosis in
gastric cancer
3. Monday,
January 23,
2023
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Indicators of LN involvement
Tumor length
Tumor short diameter
Tumor area
Histopathologic grade
The ratio of preoperative platelets/lymphocytes
The ratio of neutrophils/lymphocytes
Various inflammatory indicators
Studies reported that coagulation factors may
mediate invasion and migration in gastric cancer
4. Monday,
January 23,
2023
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Pathophysiology
The coagulation process mainly comprises
Platelet activation
Adhesion
Aggregation
Deposition of the fibrin network
Maturation of the fibrin network
Activation of the coagulation system, including platelet activation, can also
induce the production of tumor growth factors and can lead to tumor
metastasis
5. Monday,
January 23,
2023
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Components of the coagulation system may be involved in mediating
the invasion and migration of malignant tumors.
Moreover there is correlations between coagulation-related factors and
gastric cancer tumor stage.
Lymph node metastasis in patients of gastric cancer correlated with
multiple preoperative coagulation-related factors.
1. platelet level is higher with LN metastasis. platelet levels in patients at a
low N stage are lower than those of patients with a higher N stage.
platelets can enhance the malignant behavior of gastric cancer cells,
including invasion and migration, through direct contact with gastric cancer
cells
2. Fibrinogen level is higher in LN involvement.
6. Monday,
January 23,
2023
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Antiplatelet drugs
Antiplatelet drugs may play an important role in preventing
1. Gastric cancer progression
2. Proliferation
3. Migration
4. Reducing tumor cell metastasis
5. Reducing microvascular density
7. Monday,
January 23,
2023
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Fibrinogen
Fibrinogen may promote the metastasis of circulating tumor cells
through several possible mechanisms.
1. Fibrinogen may serve as an important molecular bridge between
tumor cells, platelets, and endothelial cells,
2. Fibrinogen-like protein 1 may promote the proliferation, invasion,
and migration of gastric cancer cells by participating in the
epithelial mesenchymal transition (EMT) of cells
8. D-dimer
D-dimer is a stable end product of the degradation
of cross-linked fibrin as a result of enhanced fibrin
formation and fibrinolysis, indicates
hyperfinrogenemia
Monday,
January 23,
2023
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