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

Carmen Hernández; Josune Orbe; Carmen Roncal; Maria Alvarez-Hernandez; Sara Martinez de Lizarrondo; Maria T. Alves; Jesus García Mata; José A. Páramo

doi:10.1160/TH13-02-0122

Thrombosis and Haemostasis, Table of Contents

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

¹Servicio de Hematología, Complejo Hospitalario Universitario de Ourense, Spain

,

Josune Orbe

²Atherothrombosis Lab, CIMA, University of Navarra, Pamplona, Spain

,

Carmen Roncal

²Atherothrombosis Lab, CIMA, University of Navarra, Pamplona, Spain

,

Maria Alvarez-Hernandez

³Departamento de Bioestadistica, Facultad de Medicina de Granada, Spain

,

Sara Martinez de Lizarrondo

²Atherothrombosis Lab, CIMA, University of Navarra, Pamplona, Spain

,

Maria T. Alves

⁴Unidad de Investigación, Complejo Hospitalario Universitario de Ourense, Spain

,

Jesus García Mata

⁵Servicio de Oncología, Complejo Hospitalario Ourense, Spain

,

José A. Páramo

²Atherothrombosis Lab, CIMA, University of Navarra, Pamplona, Spain

⁶Servicio de Hematología, Clínica Universidad de Navarra, Pamplona, Spain

› Author Affiliations

Abstract

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

Full Text

References

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