Tumor cells interact with the hemostatic system in various ways and may thus influence malignant growth and spread. MC28 fibrosarcoma cells possess a potent procoagulant activity (PCA) and form lung tumors following intravenous injection. The aim of this work was to study the relationship between PCA, intravascular coagulation and lung seeding in the MC28 model. MC28 cells were injected into control, warfarinized and heparinized hooded Lister rats. Coagulation changes were monitored by thromboelastography (TEG) and Sonoclot™ analysis (SA), lung fibrin formation by light and electron microscopy, tumor seeding by macroscopic counting and tumor cell and platelet deposition in the lungs by radiolabelling. PCA was measured by chromogenic assay. MC28 PCA was characterized as a tissue factorfactor VIIa complex that probably arose during cell culture or disaggregation of solid tumors. Injection of tumor cells caused marked coagulopathy and was rapidly (within 30 min) followed by fibrin deposition in the lungs and accumulation of radiolabelled platelets. Heparin and warfarin significantly reduced lung seeding (p <0.001) and reduced retention of radiolabelled tumor cells in the pulmonary circulation (p <0.01). Inhibition of cellular PCA by prior treatment with con- canavalin A markedly reduced intravascular coagulation and lung seeding.
We conclude that MC28 cells cause intravascular coagulation as a direct result of their procoagulant activity. The data suggest that tumor cells form complexes with platelets and fibrin which are retained in the lungs long enough for extravasation and seeding to occur.
Anticoagulation reduces tumor cell-platelet-fibrin complex formation, decreasing the time spent in the lungs and thereby reduces seeding. Thus, the antitumor effect of warfarin, at least in the MC28 model, is due to its anticoagulant action.
References
1
Rickies FR,
Levine M,
Edwards RL.
Hemostatic alterations in cancer patients. Cancer Metastasis Rev 1992; 11: 237-238
5
Lanir N,
Ciano PS,
van de Water L,
McDonagh J,
Dvorak AM,
Dvorak HF.
Macrophage migration in fibrin gel matrices.II. Effects of clotting factor XIII, fibronectin and glycosaminoglycan content on cell migration J Immunol 1988; 140: 2340-2349
9
Smith GF,
Neubauer BL,
Sundboom JL,
Best KL,
Goode RL,
Tanzer LR,
Morriman RL,
Frank JD,
Herrman RG.
Correlation of the in vivo anticoagulant, antithrombotic and antimetastatic efficacy of warfarin in the rat. Thromb Res 1988; 50: 163-174
12
Chang JD,
Hall TC.
In vitro effect of sodium warfarin on DNA and RNA synthesis in mouse L1210 leukemia cells and Walker tumor cells. Oncology 1988; 28: 232-237
13
Edwards RL,
Morgan DL,
Rickies FR.
Animal tumor procoagulants: Registry of the Subcommittee on Haemostasis and Malignancy of the Scientific and Standardization Committee, International Society of Thrombosis and Haemostasis. Thromb Haemost 1990; 63: 133-138
14
Edwards RL,
Silver J,
Rickies FR.
Human tumor procoagulants: Registry of the Subcommittee of Haemostasis of the Scientific and Standardization Committee, International Society on Thrombosis and Haemostasis. Thromb Haemost 1993 69: 205-213
18
Pangasnan RS,
Devereux D,
Decunzo LP,
Karp GI.
The production of a factor X activator by a methylcholanthrene-induced rat fibrosarcoma. Thromb Haemost 1992; 68: 407-412
21
Alexander P,
Murphy P,
Skipper D.
Preferential growth of blood-borne cancer cells at sites of metastasis – A growth promoting role of macrophages. In: Cancer Metastasis.
Prodi G,
Liotta LA,
Lollini P,
Garbisa S,
Gorini S,
Heilman K.
eds
Plenum Press; New York: 1988. pp 245-251
23
Fasco MJ,
Eagan GE,
Wilson AC,
Gierthy JF,
Lincoln DL.
Loss of metastatic and primary tumor factor X-activator capabilities by Lewis Lung carcinoma cells cultured in vitamin K-dependent protein-deficient serum. Cancer Res 1988; 48: 6504-6509
24
Fasco MJ,
Wilson AC,
Lincoln D,
Gierthy J.
Evidence for a warfarin- sensitive serum factor that participates in factor X activation by Lewis Lung tumor cells. Int J Cancer 1987; 39: 631-637
26
Crissman JD,
Hatfield J,
Shaldenbrand M,
Sloane BF,
Honn KV.
Arrest and extravasation of B16 amelanotic melanoma in murine lungs: a light and electron microscope study. Lab Invest 1985; 53: 470-478
27
Pearlstein E,
Salk PL,
Yogeeswaran G,
Karpatkin S.
Correlation between spontaneous metastasic potential and platelet-aggregating activity. Proc Natl Acad Sci USA 1980; 77: 4336-4339
28
Francis JL,
Carty N,
Amirkhosravi M,
Loizidou M,
Cooper A,
Taylor I.
The Effect of Warfarin and Factor-VII on Tissue Procoagulant Activity and Pulmonary Seeding. Br J Cancer 1992; 65: 329-334
32
Donati MB,
Roncaglioni MC,
Falanga A,
Casali B,
Semerao N.
Vitamin K-dependent procoagulant in cancer cells: a potential target for the antimetastatic effect of warfarin. Haemostasis 1986; 16: 288-294
33
Purushotham AD,
McCulloch P,
George WD.
Enhancement of pulmonary tumour seeding by human coagulation factors II, IX, X - an investigation into the possible mechanisms involved. Br J Cancer 1991; 64: 513-517
34
Fiore MM,
Neuenschwander PF,
Morrissey JH.
An unusual antibody that blocks tissue factor/factor-VIIa function by inhibiting cleavage only of macromolecular substrates. Blood 1992; 80: 3127-3134