[Clinical significance of protein Z detection in patients with malignant tumors].

BACKGROUND & OBJECTIVE: The blood of the patients with malignant tumors is in hypercoagulable state; its correlation to tumor migration evokes more and more attentions. Protein Z (PZ), a newly found anti-coagulation factor, is a vitamin K-dependent plasma protein which is synthesized by the liver. Its structure is very similar to the vitamin K-dependent coagulation factors, such as FXII, FIX, FX, and protein C, but its physiologic function and clinical significance are unclear. The alteration of PZ level correlates with the increased risk of coagulating abnormality-caused diseases, but its alteration in solid tumors is seldom reported. This study was to explore clinical significance of PZ and the correlation of PZ level to FXII:C; FIX:C and FX:C levels in malignant tumors. METHODS: Plasma levels of PZ, FXII:C, FIX:C, FX:C, and FX:Ag of 80 patients with malignant tumors (MT group) and 80 healthy donors (control group) were detected; their correlations were analyzed. RESULTS: The level of PZ was significantly lower in MT group than in control group [(1 210.89+/-251.13) ng/ml vs. (2,378.83+/-429.51) ng/ml, P<0.01], but the levels of FXII:C, FX:C, and FX:Ag were significantly higher in MT group than in control group [(162.42+/-36.57)% vs. (114.78+/-28.96)%, (120.27+/-33.96)% vs. (79.23+/-19.46)%, and (133.66+/-35.51)% vs. (93.0+/-17.73)%, P<0.01]. The levels of FIX:C were (119.86+/-56.38)% in MT group, and (109.21+/-36.46)% in control group (P>0.05). The level of PZ was negatively correlated with the levels of FXII:C; FX:C, and FX:Ag (P<0.01), but had no correlation with the level of FIX:C (P>0.05). The level of PZ was significantly lower in stage III-IV (locally advanced stage-advanced stage) patients than in stage II patients [(998.32+/-117.72) ng/ml vs. (1,326.69+/-245.70) ng/ml, P<0.01], but the levels of FXII:C, FX:C, and FX:Ag were significantly higher in stage III-IV patients than in stage II patients [(206.76+/-28.63)% vs. (136.09+/-26.80)%, (162.53+/-32.92)% vs. (101.89+/-23.44)%, (168.03+/-25.97)% vs. (105.41%+/-13.86)%, P<0.01]. CONCLUSIONS: PZ level is obviously decreased in the patients with malignant tumors, and negatively correlated with FXII:C, FX:C, and FX:Ag. PZ level descends along with the progression of malignant tumors, and maybe a poor prognostic factor of malignant tumors.

[Clinical significance of protein Z alteration in patients with cardio-cerebral thrombotic diseases].

OBJECTIVE: To study the alteration of protein Z (PZ) in patients with cardio-cerebral thrombotic diseases, its clinical significance and relations with FX. METHODS: PZ and FX:Ag were measured by ELISA, and plasma FX:C by first stage method. In 170 patients with acute ischemic stroke (AIS), 40 acute myocardial infarction (AMI) and 60 healthy adults as contrast, PZ, FX:C and FX:Ag were measured and compared between incipience and recurrence, different ages and genders. RESULTS: In AIS and AMI groups, PZ levels decreased significantly to (940.02 +/- 229.82) microg/L and (1071.44 +/- 180.52) microg/L, respectively \[the contrast group was (2257.97 +/- 479.76) microg/L, P < 0.001\]. But FX:C and FX:Ag raised to (136.73 +/- 34.93)% and (135.54 +/- 54.39)% in AIS group; and to (139.53 +/- 29.18)%, (129.75 +/- 21.91)% in AMI group, respectively, while in the contrast group they were (94.33 +/- 22.00)% and (77.22 +/- 13.19)% (P < 0.001). In the comparative research between the AIS group, AMI group and the contrast group, PZ level was clearly found to negatively relate to the level of FX:C and FX:Ag (P < 0.001). Meanwhile, PZ level, FX:C and FX:Ag in recur-AIS group and recur-AMI group exhibited significant differences (P < 0.05) from those in the primary AIS and AMI groups, suggesting that the decrease of PZ levels reflected the pathological process of the disease. In addition, PZ level gradually decreased with the increase of age (P < 0.05), while FX:C and FX:Ag had no relations with age (P > 0.05). No correlation was found in sex with PZ level, FX:C, FX:Ag (P > 0.05). CONCLUSION: PZ level was significantly decreased in AIS and AMI patients and was negatively related to FX:C and FX:Ag. The mechanism leading to FX increase may partially related with the decreased of PZ. PZ level was different in the primary and recurrent disease and was gradually decreased with the increase of age. Lack of PZ might be a etiological factor of cardio-cerebral thrombotic diseases.