title: Microparticle-associated tissue factor activity, venous thromboembolism and mortality in pancreatic, gastric, colorectal and brain cancer patients.
abstract: BACKGROUND
  Tissue factor (TF) expression by tumors contributes to tumor growth. Release of TF-positive microparticles (MPs) may contribute to venous thromboembolism (VTE).
  
  
  OBJECTIVE
  To conduct a prospective cohort study to determine whether elevated MP-associated TF (MP-TF) activity is predictive of VTE and mortality in four cancer types.
  
  
  METHODS
  We determined MP-TF activity in pancreatic, gastric, colorectal and brain cancer patients. We used a chromogenic endpoint assay for all patients and also a chromogenic kinetic assay for patients with pancreatic and brain cancer.
  
  
  RESULTS
  During follow-up, 12/60 (20%) pancreatic, 6/43 (14%) gastric, 12/126 (10%) colorectal and 19/119 (16%) brain cancer patients developed VTE; 46/60 (77%), 30/43 (70%), 47/126 (37%) and 67/119 (56%), respectively, died. MP-TF activity levels were highest in pancreatic cancer. We did not find a statistically significant association of MP-TF activity with the risk of VTE in any of the four cancer types by using two statistical methods. An association of MP-TF activity with the risk of mortality was detected in pancreatic cancer with the endpoint assay (hazard ratio [HR] 1.8 and 95% confidence interval [CI] 1.4-2.3 per doubling of activity, P < 0.001) and the kinetic assay (HR 1.2, 95% CI 1.1-1.4, P < 0.001); adjustment for type of treatment was not performed. In pancreatic cancer, MP-TF activity correlated with D-dimer level (endpoint assay, r = 0.51; chromogenic assay, r = 0.48), and a correlation between assays (r = 0.61) was found.
  
  
  CONCLUSIONS
  MP-TF activity was not associated with future VTE in pancreatic, gastric, colorectal and brain cancer. However, we found a strong association of MP-TF activity with mortality in pancreatic cancer. MP-TF activity might be reflective of an aggressive pancreatic cancer phenotype.
authors.affiliation: Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Thaler
authors.forename: C
authors.initials: C
authors.lastname: Ay
authors.forename: N
authors.initials: N
authors.lastname: Mackman
authors.forename: R M
authors.initials: RM
authors.lastname: Bertina
authors.forename: A
authors.initials: A
authors.lastname: Kaider
authors.forename: C
authors.initials: C
authors.lastname: Marosi
authors.forename: N S
authors.initials: NS
authors.lastname: Key
authors.forename: D A
authors.initials: DA
authors.lastname: Barcel
authors.forename: W
authors.initials: W
authors.lastname: Scheithauer
authors.forename: G
authors.initials: G
authors.lastname: Kornek
authors.forename: C
authors.initials: C
authors.lastname: Zielinski
authors.forename: I
authors.initials: I
authors.lastname: Pabinger
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000097:blood* / Q000150:complications / Q000401:mortality; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005770:Gastrointestinal Neoplasms / Q000097:blood* / Q000150:complications / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D015996:Survival Rate; D013925:Thromboplastin / Q000378:metabolism*; D054556:Venous Thromboembolism / Q000097:blood* / Q000150:complications / Q000401:mortality
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D013925:Thromboplastin