title: Expression of Tissue Factor in Epithelial Ovarian Carcinoma Is Involved in the Development of Venous Thromboembolism.
abstract: Our 2007 study of 32 patients with ovarian cancer reported the possible involvement of tissue factor (TF) in the development of venous thromboembolism (VTE) before treatment, especially in clear cell carcinoma (CCC). This follow-up study further investigated this possibility in a larger cohort.
  
  
  
  We investigated the intensity of TF expression (ITFE) and other variables for associations with VTE using univariate and multivariate analyses in 128 patients with epithelial ovarian cancer initially treated between November 2004 and December 2010, none of whom had received neoadjuvant chemotherapy. Before starting treatment, all patients were ultrasonographically screened for VTE. The ITFE was graded based on immunostaining of surgical specimens.
  
  
  
  Histological types were serous carcinoma (n = 42), CCC (n = 12), endometrioid carcinoma (n = 15), mucinous carcinoma (n = 53), and undifferentiated carcinoma (n = 6). The prevalence of VTE was significantly higher in CCC (34%) than in non-CCC (17%, P = 0.03). As ITFE increased, the frequencies of CCC and VTE increased significantly (P < 0.001 and P = 0.014, respectively). Multivariate analysis identified TF expression and pretreatment dimerized plasmin fragment D level as significant independent risk factors for VTE development. These factors showed particularly strong impacts on advanced-stage disease (P = 0.021).
  
  
  
  The 2007 cohort was small, preventing multivariate analysis. This study of a larger cohort yielded stronger evidence that the development of VTE in epithelial ovarian cancer may involve TF expression in cancer tissues.
authors.affiliation: Faculty of Medicine, Departments of *Obstetrics and Gynecology and †Clinical Trial and Clinical Epidemiology, and ‡Department of Pathology, Tsukuba Human Tissue Diagnostic Center, University of Tsukuba, Tsukuba, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Sakurai
authors.forename: Koji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Gosho
authors.forename: Akiko
authors.initials: A
authors.lastname: Sakata
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Hosokawa
authors.forename: Yuri
authors.initials: Y
authors.lastname: Tenjimbayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Katoh
authors.forename: Ayumi
authors.initials: A
authors.lastname: Shikama
authors.forename: Haruna
authors.initials: H
authors.lastname: Komiya
authors.forename: Hiroo
authors.initials: H
authors.lastname: Michikami
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Tasaka
authors.forename: Azusa
authors.initials: A
authors.lastname: Akiyama-Abe
authors.forename: Sari
authors.initials: S
authors.lastname: Nakao
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ochi
authors.forename: Mamiko
authors.initials: M
authors.lastname: Onuki
authors.forename: Takeo
authors.initials: T
authors.lastname: Minaguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: Toyomi
authors.initials: T
authors.lastname: Satoh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000096:biosynthesis; D000077216:Carcinoma, Ovarian Epithelial; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D013925:Thromboplastin / Q000096:biosynthesis*; D054556:Venous Thromboembolism / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D013925:Thromboplastin