Tumour expresion of tissue factor and tissue factor pathway inhibitor in ovarian cancer- relationship with venous thrombosis risk

article i nfo Article history: Introduction: Ovarian cancer is known to display a particular association with venous thromboembolism (VTE) with reports up to 42% of patients developing thromboembolic complications. Tissue Factor (TF) and its inhibitor Tissue Factor Pathway Inhibitor (TFPI) have been implicated in VTE risk in cancer. The aim of this study was to measure tumour derived TF and TFPI and to investigate their potential role in VTE in ovarian cancer patients. Methods: TF and TFPI mRNA expression was measured using TaqMan real time PCR in 99 ovarian tumour samples. Nineteen cases complicated by VTE were matched to 19 cases without VTE. TF and TFPI protein levels weremeasuredusingELISAandimmunohistochemistrywasusedtolocalizeTFexpression.TheroleofTFexpres- sion on overall survival was also determined. Results: TF mRNA and protein expression was increased in tumours from patients with clear cell carcinoma (p b 0.001). TF protein expression was also increased in endometroid carcinoma (P b 0.01) compared with benign tumours. TFPI mRNA expression was increased in clear cell carcinoma (P b 0.01). TF mRNA and antigen level was increased in malignant tumours of patients who developed VTE compared with matched malignant otumours of patients who remained thrombosis free (P b 0.01). There was no difference in TFPI expression between the two groups. Conclusion:TFexpressioninovariancancerissignificantlyhigherinpatientswhodevelopVTE.TFexpressionwas increasedinclearcellovariancancerandendometroidcancerandthismayexplainthehigherriskofVTEinthese subgroups. TF derived from these tumours may be the trigger for VTE in ovarian cancer.