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Thromb Haemost 2013; 110(03): 598-608
DOI: 10.1160/TH13-02-0122
Cellular Proteolysis and Oncology
Schattauer GmbH

Tissue factor expressed by microparticles is associated with mortality but not with thrombosis in cancer patients

Carmen Hernández
1   Servicio de Hematología, Complejo Hospitalario Universitario de Ourense, Spain
,
Josune Orbe
2   Atherothrombosis Lab, CIMA, University of Navarra, Pamplona, Spain
,
Carmen Roncal
2   Atherothrombosis Lab, CIMA, University of Navarra, Pamplona, Spain
,
Maria Alvarez-Hernandez
3   Departamento de Bioestadistica, Facultad de Medicina de Granada, Spain
,
Sara Martinez de Lizarrondo
2   Atherothrombosis Lab, CIMA, University of Navarra, Pamplona, Spain
,
Maria T. Alves
4   Unidad de Investigación, Complejo Hospitalario Universitario de Ourense, Spain
,
Jesus García Mata
5   Servicio de Oncología, Complejo Hospitalario Ourense, Spain
,
José A. Páramo
2   Atherothrombosis Lab, CIMA, University of Navarra, Pamplona, Spain
6   Servicio de Hematología, Clínica Universidad de Navarra, Pamplona, Spain
› Author Affiliations Financial Support: This work was partially supported by Fundación Cabaleiro Goas, Ourense, Spain
Further Information

Publication History

Received: 13 February 2013

Accepted after major revision: 07 June 2013

Publication Date:
22 November 2017 (online)

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Summary

A prothrombotic state is one of the hallmarks of malignancy and a major contributor to morbidity and mortality in cancer patients. Tissue factor (TF) is often overexpressed in malignancy and is a prime candidate in predicting the hypercoagulable state. Moreover, increased number of TF-exposing microparticles (MPs) in cancer patients may contribute to venous thromboembolism (VTE). We have conducted a prospective cohort study to determine whether elevated TF antigen, TF activity and TF associated to MPs (MPs-TF) are predictive of VTE and mortality in cancer patients. The studied population consisted of 252 cancer patients and 36 healthy controls. TF antigen and activity and MPs-TF were determined by ELISA and chromogenic assays. During a median follow-up of 10 months, 40 thrombotic events were recorded in 34 patients (13.5%), and 73 patients (28.9%) died. TF antigen and activity were significantly higher in patients than in controls (p<0.01) mainly in patients with advanced stages, whereas no differences were observed for TF activity of isolated MPs. We did not find a statistically significant association of TF variables with the risk of VTE. Multivariate analysis adjusting for age, sex, type of cancer and other confounding variables showed that TF activity (p<0.01) and MPs-TF activity (p<0.05) were independently associated with mortality. In conclusion, while TF variables were not associated with future VTE in cancer patients, we found a strong association of TF and MPs-TF activity with mortality, thus suggesting they might be good prognostic markers in cancer patients.

Keywords

Cancer - venous thromboembolism - tissue factor - microparticles - prognosis
 

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