title: Tissue Factor Pathway Inhibitor-1 Is a Valuable Marker for the Prediction of Deep Venous Thrombosis and Tumor Metastasis in Patients with Lung Cancer.
abstract: Activation of blood coagulation contributes to cancer progression. Tissue factor pathway inhibitor-1 (TFPI-1) is the main inhibitor of extrinsic coagulation pathway. The aim of this study is to assess the predicting significance of TFPI-1 for thrombotic complication and metastasis in lung cancer patients. Total of 188 non-small cell lung cancer (NSCLC) patients were included in this study. Plasma TFPI-1, D-dimer (D-D), antithrombin (AT), Fibrinogen (Fbg), and coagulating factor VIII activity (FVIII:C) were measured. In NSCLC patients, significantly decreased TFPI-1 and AT and increased D-D, Fbg, and FVIII:C levels were observed, and there was a significant correlation between TFPI-1 and other hemostatic parameters (P< 0.001, resp.). NSCLC patients with deep venous thrombosis (DVT) or metastasis had significantly lower TFPI-1 levels than those without DVT or metastasis (P< 0.01, resp.). Multivariate regression revealed that TFPI-1 acted as a predictor for DVT or tumor metastasis in NSCLC patients [OR: 4.15 or 3.28,P< 0.05, resp.]. The area under ROC curve of TFPI-1 was 0.905 (95% CI, 0.842~0.967) or 0.828 (95% CI, 0.742~0.915) for predicting DVT or metastasis (P< 0.001, resp.). The optimal point of TFPI-1 was 57.7 or 54.3 ng/mL for predicting DVT or metastasis, respectively. Combination of TFPI-1 and D-D measurements can improve the predicting power for DVT or metastasis in NSCLC patients. Our findings suggested that TFPI-1 was a valuable predictor of DVT and tumor metastasis in NSCLC patients.
authors.affiliation: Center of Laboratory Medicine, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
authors.forename: Xianming
authors.identifier: 0000-0002-5631-408X
authors.initials: X
authors.lastname: Fei
authors.affiliation: Center of Laboratory Medicine, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
authors.forename: Huan
authors.identifier: 0000-0001-7042-3306
authors.initials: H
authors.lastname: Wang
authors.affiliation: Center of Laboratory Medicine, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
authors.forename: Wufeng
authors.initials: W
authors.lastname: Yuan
authors.affiliation: Center of Laboratory Medicine, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
authors.forename: Mingyi
authors.identifier: 0000-0002-2707-518X
authors.initials: M
authors.lastname: Wo
authors.affiliation: Center of Laboratory Medicine, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
authors.forename: Lei
authors.identifier: 0000-0002-2060-6216
authors.initials: L
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000150:complications / Q000473:pathology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D016015:Logistic Models; D008175:Lung Neoplasms / Q000097:blood* / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D012372:ROC Curve; D012307:Risk Factors; D020246:Venous Thrombosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D008074:Lipoproteins; C036309:fibrin fragment D; C051928:lipoprotein-associated coagulation inhibitor