In pancreatic cancer, significantly elevated plasma levels of fibrinogen, factor (F)VIII and D-dimer have been observed, whereas diminished levels of protein C and antithrombin III have been reported, although levels might change during tumour progression.28,29 More importantly, pancreatic cancer cells directly produce a number of factors, or influence a number of activities, that promote coagulation (Fig. 1). The gene discussed is SERPINC1; the disease is pancreatic neoplasm.