title: Microvesicle-associated tissue factor procoagulant activity for the preoperative diagnosis of ovarian cancer.
abstract: Tissue factor (TF) is involved in tumor growth and metastasis and contributes to venous thromboembolism (VTE) in cancer, including gynecological malignancies. The diagnostic value of microvesicle-associated TF procoagulant activity (MV TF PCA) in women with suspected ovarian cancer, however, has not been studied.
  
  
  
  To evaluate MV TF PCA as a diagnostic tool in women with an ovarian mass of unknown etiology and as a predictive biomarker for perioperative VTE.
  
  
  
  Plasma MVs were isolated by high-speed centrifugation and analyzed for TF-specific PCA by single-stage clotting assay. In addition, plasma TF antigen and soluble P-selectin (sCD62P) were measured by ELISA.
  
  
  
  D-Dimer, MV TF PCA, and sCD62P, but not the tumor marker, CA-125, significantly differentiated patients with malignant (n=40) from those with benign tumors (n=15) and healthy controls (n=34). In cancer patients, only D-Dimer and CA-125 correlated with the FIGO stage. An abnormal D-dimer had the highest sensitivity for the diagnosis of cancer, while MV TF PCA above the ROC curve-derived cut-off value of 182U/mL had the highest specificity. By multivariate logistic regression analysis, addition of MV TF PCA conferred diagnostic benefit to the single variables, CA-125 (p=0.052) and D-dimer (p=0.019). Perioperative VTE occurred in 16% of cancer patients and was associated with an advanced FIGO stage, but not MV TF PCA. There was no difference in plasma TF antigen levels between study groups.
  
  
  
  MV TF PCA, but not plasma TF antigen, may provide valuable additional information for the diagnostic work-up of women with suspected ovarian cancer.
authors.affiliation: II. Medizinische Klinik und Poliklinik, Onkologisches Zentrum - Universitäres Cancer Center Hamburg (UCCH), Universitätsklinikum Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany.
authors.forename: Carlota
authors.initials: C
authors.lastname: Claussen
authors.affiliation: Klinik und Poliklinik für Gynäkologie, Zentrum für Operative Medizin, Universitätsklinikum Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany.
authors.forename: Alma-Verena
authors.initials: AV
authors.lastname: Rausch
authors.affiliation: Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Lezius
authors.affiliation: Florida Hospital Center for Thrombosis Research, 2566 Lee Road, Winter Park, FL 32789, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Amirkhosravi
authors.affiliation: Florida Hospital Center for Thrombosis Research, 2566 Lee Road, Winter Park, FL 32789, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Davila
authors.affiliation: Florida Hospital Center for Thrombosis Research, 2566 Lee Road, Winter Park, FL 32789, USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Francis
authors.affiliation: University of North Carolina at Chapel Hill, 111 Mason Farm Road, 2312B Medical Biomolecular Research Building, Campus Box #7126, Chapel Hill, NC 27599, USA.|K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Tromsø, Norway.
authors.forename: Yohei M
authors.initials: YM
authors.lastname: Hisada
authors.affiliation: University of North Carolina at Chapel Hill, 111 Mason Farm Road, 2312B Medical Biomolecular Research Building, Campus Box #7126, Chapel Hill, NC 27599, USA.
authors.forename: Nigel
authors.initials: N
authors.lastname: Mackman
authors.affiliation: II. Medizinische Klinik und Poliklinik, Onkologisches Zentrum - Universitäres Cancer Center Hamburg (UCCH), Universitätsklinikum Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Bokemeyer
authors.affiliation: Klinik und Poliklinik für Gynäkologie, Zentrum für Operative Medizin, Universitätsklinikum Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Schmalfeldt
authors.affiliation: Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität München (LMU), Campus Großhadern und Innenstadt, Marchioninistr. 15, 81377 München, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Mahner
authors.affiliation: II. Medizinische Klinik und Poliklinik, Onkologisches Zentrum - Universitäres Cancer Center Hamburg (UCCH), Universitätsklinikum Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany. Electronic address: langer@uke.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Langer
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood; D018394:CA-125 Antigen / Q000032:analysis / Q000097:blood; D055252:Cell-Derived Microparticles / Q000473:pathology*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006487:Hemostasis; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D010053:Ovary / Q000473:pathology; D019007:P-Selectin / Q000097:blood; D059035:Perioperative Period; D057234:Preoperative Period; D013925:Thromboplastin / Q000032:analysis*; D054556:Venous Thromboembolism / Q000097:blood / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D005338:Fibrin Fibrinogen Degradation Products; D019007:P-Selectin; C036309:fibrin fragment D; D013925:Thromboplastin
keywords: D-dimer; Microvesicles; Ovarian cancer; Tissue factor; Venous thromboembolism