thromboplastin and Bile-Duct-Neoplasms

Tissue factor (TF), the physiologic initiator of coagulation, is over-expressed in pancreatic cancer, and is associated with a pro-coagulant and pro-angiogenic state. We hypothesized that in patients with pancreaticobiliary cancers (PBC), elevated circulating microparticle-associated TF (MP-TF) activity would be associated with thrombosis and worsened survival.. Clinical data and plasma were obtained for consecutive patients with PBC seen at Roswell Park Cancer Institute from 2005-08. MP-TF activity levels were measured using a TF-dependent FXa generation assay.. The study population comprised 117 patients, including pancreatic (n=80), biliary (n=34) or unknown primary histologically consistent with PBC (n=3). Of these, 52 patients (44.5%) experienced thromboembolism, including pulmonary embolism (n=15), deep venous thrombosis (n=21) and other arterial or venous events (n=32). Mean TF was 2.15 (range 0.17- 31.01) pg/mL. Median survival was 98.5 days for MP-TF activity ≥ 2.5 pg/mL versus 231 days for MP-TF activity<2.5 pg/mL (p<0.0001). In multivariate analysis, elevated MP-TF activity was associated with both VTE (OR 1.4, 95% CI 1.1-1.6) and mortality (HR 2.5, 95% CI 1.4-4.5).. Elevated circulating MP-TF activity is associated with thrombosis and worsened survival in patients with PBC. MP-TF activity as a prognostic biomarker warrants further prospective evaluation.

Topics: Adult; Aged; Aged, 80 and over; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Cell-Derived Microparticles; Cohort Studies; Female; Humans; Male; Middle Aged; Pancreatic Neoplasms; Prognosis; Survival Analysis; Thromboembolism; Thromboplastin

Topics: Aged; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Blood Coagulation; Chronic Disease; Disseminated Intravascular Coagulation; Fibrinogen; Humans; Male; Prothrombin; Thrombelastography; Thrombophlebitis; Thromboplastin

Topics: Adult; Aged; Bile Duct Neoplasms; Biliary Tract Diseases; Female; Humans; Liver Diseases; Liver Neoplasms; Male; Middle Aged; Thromboplastin