thromboplastin and Kidney-Neoplasms

Tissue factor (TF) is the main physiological initiator of blood coagulation and may be important in the biology of a variety of solid malignancies, particularly where angiogenesis is a critical factor. TF is frequently encrypted in the plasma membrane of cells in contact with blood, and is exposed only after stimulation by certain agonists. Cancer cells variably express TF and cancer cell lines which exhibit multidrug resistance contain more TF than parental cells. TF is increased in both tumour-associated macrophages and blood monocytes and has been implicated in abnormal coagulation activation seen in patients with inflammatory conditions and cancer. TF is also found in urine (uTF) in a lipid-associated form, probably of kidney origin. uTF levels can be assayed in a cost-effective manner and may be clinically important, particularly in patients with renal disorders and malignancy. uTF levels are not significantly affected by age, gender or cigarette smoking.

Topics: Age Factors; Biomarkers, Tumor; Blood Coagulation; Drug Resistance, Neoplasm; Enzyme-Linked Immunosorbent Assay; Humans; Kidney; Kidney Diseases; Kidney Neoplasms; Sex Factors; Thromboplastin

The coagulation function in carcinoma patients is abnormal, but in renal cell carcinoma the extent and relationships of coagulation function remain unclear. This study retrospectively investigated the relationships between coagulation function, clinical stage and metastasis in patients with renal cell carcinoma.. A total of 350 consecutive patients admitted to our Urology Department from 2004 to 2010 were diagnosed with renal cell carcinoma by histopathologic examination and were included in this study. A total of 231 cases of renal benign tumors were considered as the control group. Fibrinogen, prothrombin time, activated partial thromboplastin time and international normalized ratio were evaluated in all subjects. Tumor size, clinical stage, lymph node metastasis, and distant metastasis were evaluated using radiologic imaging, intraoperative findings, and histological studies.. The preoperative plasma fibrinogen levels of patients with renal cell carcinoma ((383.9 ± 146.7) mg/dl) were significantly higher than those of the control group ((316.7 ± 62.0) mg/dl) (P < 0.01). We divided the renal cell carcinoma group into stages Ia, Ib, II, III, and IV. The fibrinogen values were (315.6 ± 64.6) mg/dl, (358.3 ± 91.1) mg/dl, (465.6 ± 164.7) mg/dl, (500.0 ± 202.1) mg/dl, and (585.8 ± 179.7) mg/dl, respectively. There were no significant differences in fibrinogen values between stage Ia and control groups. However, results of other stages showed significant differences when compared to control group values (P < 0.01). Using the cutoff value of 440 mg/dl, which defines hyperfibrinogenemia, plasma fibrinogen levels had a positive predictive value of 39.8% and a negative predictive value of 93.3% for predicting distant metastasis, with a sensitivity of 64.7% and specificity of 83.3%.. Preoperative plasma fibrinogen levels are elevated in patients with renal cell carcinoma with distant metastasis or lymph node metastasis. Potential metastasis is more likely if the tumor size larger than 4 cm. Increased preoperative plasma fibrinogen levels, especially hyperfibrinogenemia, may be an indicator of metastasis.

Topics: Adult; Aged; Blood Coagulation; Carcinoma, Renal Cell; Female; Fibrinogen; Humans; Kidney Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Staging; Retrospective Studies; Thromboplastin

There is potential interaction between malignant cell growth and the coagulation pathway. Recent studies suggest that tissue factor, a primary initiator of the extrinsic coagulation pathway, is expressed in various solid tumors in association with increased angiogenesis. To our knowledge we report for the first time the detection of tissue factor expression by immunohistochemistry in Wilms tumors and its correlation with clinical outcomes.. Tissue factor expression detected by immunohistochemistry was assessed in 41 formalin fixed, paraffin embedded Wilms tumor cases treated at university hospitals. We correlated findings with tumor recurrence and cancer specific survival.. Positive immunohistochemistry detection of tissue factor was observed in 88.3% of the tumors analyzed. Tissue factor on immunohistochemistry was associated with tumor recurrence and survival (p = 0.01 and 0.02, respectively). Increased immunohistochemical detection of tissue factor was the most important risk factor for recurrence and mortality in our population on bivariate and multivariate analysis.. Tissue factor is a promising research subject as a prognostic factor for Wilms tumor. More studies are needed to clarify the mechanisms by which tissue factor affects cancer progression and outcome, and its potential role as a therapeutic target.

Topics: Child; Child, Preschool; Female; Humans; Immunohistochemistry; Infant; Kidney Neoplasms; Male; Prognosis; Survival Rate; Thromboplastin; Wilms Tumor

At present thrombosis of the superior vena cava is an uncommon event that is now more frequently associated with diagnostic or therapeutic catheterization. If an apparent spontaneous thrombosis occurs, malignancy should be considered in the differential diagnosis. One case of clinically symptomatic thrombosis of the internal jugular, subclavian, and superior vena cava is presented. We detected an asymptomatic left renal cell carcinoma in a 54-year-old patient and nephrectomy was performed. Increased blood coagulability as part of a paraneoplastic syndrome was considered to be the possible etiology. In patients with otherwise unexplained superior vena cava thrombosis, examination not only of the head and neck but also of the abdomen, retroperitoneum, and pelvis should be pursued. A review of the literature pertinent to this rare case is provided.

Topics: Carcinoma, Renal Cell; Diagnostic Imaging; Humans; Incidental Findings; Jugular Veins; Kidney; Kidney Neoplasms; Male; Middle Aged; Neoplasm Proteins; Nephrectomy; Paraneoplastic Syndromes; Pulmonary Embolism; Subclavian Vein; Superior Vena Cava Syndrome; Thromboplastin; Thrombosis

The aim of study was to evaluate TF activity and TFPI concentration in patients with haematological malignancies and urinary tract tumors. TFPI concentration and activity and TF concentration were measured in 20 patients suffering from acute myeloblastic leukaemia (AML), 21 patients with chronic myelogenous leukaemia (CML), 17 patients with chronic lymphatic leukaemia (CLL), 16 patients with multiple myeloma (MM) and 65 healthy adults. TFPI and TF concentrations were measured also in patients with renal cell carcinoma (n = 12) and bladder cancer (n = 17) and patients with benign prostatic hyperplasia (BPH) (n = 15). Patients with AML, CML, CLL, and cancer revealed elevated TFPI concentrations. Patients with AML, CML, CLL, MM showed decreased TFPI activity. However TFPI concentration correlated inversely with TFPI activity only in the AML group. No significant changes were observed in TF concentrations in all investigated groups.

Topics: Biomarkers, Tumor; Carcinoma, Renal Cell; Case-Control Studies; Enzyme-Linked Immunosorbent Assay; Female; Humans; Kidney Neoplasms; Leukemia; Leukemia, Lymphocytic, Chronic, B-Cell; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid, Acute; Lipoproteins; Male; Multiple Myeloma; Prostatic Hyperplasia; Thromboplastin; Urinary Bladder Neoplasms; Urologic Neoplasms

From April 1986 to September 2000, 122 MRCC patients were treated by monthly intralymphatic injections (containing a mean of 573 IL-2 U and 26 x 10(6) LAK cells) and i.m. administration of IFN and TF; 71 patients also received a 3-day cycle of monthly IL-2 inhalations with a mean of 998 daily U. MRCC cases not treated by immunotherapy (n = 89) represent our historical controls. Adverse clinical side effects related to treatment were negligible. CR (n = 11) and PR (n = 13) were noticed in 24/122 patients. Of 24 responding patients, 17 resumed progression, whereas 7 remain in remission 11-69 months later. The overall median survival of treated patients (28 months) was 3.5-fold higher than the median survival of historical controls (7.5 months), and a Kaplan-Meier curve showed 25% survival 11 years after the beginning of immunotherapy. Apparently, the addition of IL-2 by inhalation improved survival. The present immunotherapy protocol appears to be efficacious, safe, devoid of adverse side effects, far less costly than others and able to offer a good quality of life to MRCC patients; if confirmed in a multicenter trial, it could set the basis for developing low-dose immunomodulatory treatments.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Immunotherapy, Adoptive; Interferons; Interleukin-2; Kidney Neoplasms; Killer Cells, Natural; Lung Neoplasms; Male; Middle Aged; Thromboplastin

Procoagulant activity of pairs of cell lines, which were derived from the same original cell type but which possess different growth characteristics and metastatic properties, was examined. The following characteristics were considered suggestive of a greater likelihood of metastatic potential: high histological grade; establishment of the line from a metastatic rather than a nonmetastatic cancer; increased tumorigenicity in nude mice; and/or estrogen receptor-negative mammary cancer. Procoagulant activity was evaluated by a two stage clotting assay. Procoagulant activity was highly variable, with up to a 1,300-fold difference, among the cancer cell lines examined. The rate of clot formation was factor VII dependent and was totally inhibited by an anti tissue factor monoclonal antibody, indicating that tissue factor was the only significant procoagulant present in these cancer cells. Tissue factor antigen expression, evaluated by ELISA, correlated with procoagulant activity. In all pairs of cancer cell lines, those with characteristics of increased proliferative potential had increased tissue factor levels compared to cell lines that originated from the same cell type, but which possess less aggressive characteristics. Tissue factor activity in these cancer cells was increased by cell lysis or by exposure of intact cells to a calcium ionophore, similar to results previously obtained in fibroblasts. Tissue factor mRNA was evaluated by northern blot analysis using a specific probe complementary to tissue factor mRNA. The previously described predominant tissue factor mRNA species of 2.2 kb was identified in the majority of cancer cell lines examined, but tissue factor mRNA species of 3.2 to 3.4 kb were also identified.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adenocarcinoma; Blood Coagulation; Blotting, Northern; Breast Neoplasms; Carcinoma, Renal Cell; Carcinoma, Transitional Cell; Cell Line; Gastrointestinal Neoplasms; Gene Expression; Humans; Kidney Neoplasms; Neoplasm Metastasis; RNA, Messenger; Thromboplastin; Tumor Cells, Cultured

A case is reported of a 60 year-old patient with chronic disseminated intravascular coagulation (DIC) which was increased by the therapeutic embolization of a renal tumour. The patient had 2 primary carcinomas (renal and prostatic) with vertebral metastases, severe chronic anaemia (due to haematuria), and chronic DIC, with thrombocytopaenia, soluble complexes, and fibrinogen and fibrin degradation products. Therapeutic embolization of the renal artery was carried out with fragments of dura mater. Although the result was anatomically very satisfactory, the patient's condition worsened, with continuing haematuria, and development of an haematoma in the lumbar fossa. Coagulation factors and antithrombin III (AT III) concentrations decreased, whereas the activated partial thromboplastin, thrombin and reptilase times increased. The patient also suffered from acute renal failure (creatinine: 690 mumol.l-1). Treatment consisted in fluid replacement, red blood cell and platelet transfusions, 150 IU.kg-1.d-1 heparin and 20 IU.kg-1.d-1 AT III. Haematological tests returned to pre-embolization values on the ninth day. The sudden worsening in the patient's condition was probably due to the sudden massive release of tissue thromboplastins related to the renal necrosis induced by the therapeutic embolization. The use of heparin AT III in the management of this patient is discussed.

Topics: Antithrombin III; Blood Coagulation Factors; Blood Platelets; Blood Transfusion; Chronic Disease; Disseminated Intravascular Coagulation; Embolization, Therapeutic; Hematuria; Heparin; Humans; Kidney Neoplasms; Male; Middle Aged; Renal Artery; Thromboplastin

Characterization studies have been carried out on 2 cell lines (KPK 1 and KPK 13) established from human renal adenocarcinoma. KPK 1 and KPK 13 have been passaged 178 times in vitro for about 6 years and 7 months and 78 times for about 3 years an 2 months, respectively. Although morphologic differences exist between the 2 lines, each has an epithelial morphology and exhibits multilayering. Doubling time of KPK 1 and KPK 13 cells was 29 hours and 51 hours, respectively. Both KPK 1 and KPK 13 induced tumors at the site of subcutaneous injection, closely resembling the original tumor from which they were derived. Chromosome number of both cell lines was 100 per cent aneuploid and the presence of Y chromosomes was confirmed by G banding in KPK 13 cells. KPK 1 was found to have high thromboplastic and high fibrinolytic activities, whereas KPK 13 was shown to have comparatively low thromboplastic and no detectable fibrinolytic activities. These activities were detected in the serum free supernatant fraction from KPK 1 cells but were not detected in that from KPK 13 cells.

Topics: Adenocarcinoma; Aged; Animals; Cell Line; Chromosome Banding; Female; Fibrinolysis; Humans; In Vitro Techniques; Karyotyping; Kidney Neoplasms; Mice; Mice, Nude; Neoplasm Transplantation; Thromboplastin

A new epithelial cell line derived from undifferentiated carcinoma of human renal pelvis, designated KP 1, was established in vitro. The cell line has been passaged 190 times in vitro for 5 years and 9 months. The predominant cell in KP 1 was a tear-drop-shaped cell. Doubling time of the cell line was 35 h. The malignant epithelial character of this line was verified by carcinogenicity in the subcuticular layer of nude mice and by karyotypic analysis which revealed the cells to be completely aneuploid with a model chromosome number in the hypertriploid range. KP 1 cells were shown to produce both tissue thromboplastin and plasminogen activator which was immunologically identical to urokinase, the plasminogen activator in urine.

Topics: Animals; Carcinoma; Cell Line; Female; Humans; In Vitro Techniques; Karyotyping; Kidney Neoplasms; Kidney Pelvis; Mice; Middle Aged; Plasminogen Activators; Thromboplastin

Eight human upper urinary tract tumors were transplanted subcutaneously into congenitally athymic nude mice. Subcutaneous growth was obtained in three (NKPP 1, NKPP 2, and NKPU 1) at initial transplantation and they were all serially passaged up to 29, 28, and 5 passages, respectively. Their histologic appearances were similar to those of the originals. These established strains with high transplantability and differing degrees of thromboplastic and fibrinolytic activities will provide a useful model system for studying anticancer therapies and biological characteristics of upper urinary tract tumors.

Topics: Adult; Aged; Animals; Female; Fibrinolysis; Humans; Kidney Neoplasms; Male; Mice; Mice, Inbred BALB C; Middle Aged; Neoplasm Transplantation; Neoplasms, Experimental; Papilloma; Thromboplastin; Transplantation, Heterologous; Ureteral Neoplasms

Topics: Adenocarcinoma; Adult; Aged; Alkaline Phosphatase; Alpha-Globulins; Biopsy; Fatty Liver; Female; Follow-Up Studies; Hepatitis; Humans; Kidney Neoplasms; Male; Middle Aged; Postoperative Care; Preoperative Care; Prothrombin Time; Serum Albumin; Sulfobromophthalein; Thromboplastin