The clinical value of measuring tissue factor activity in patients with cancer

The association between cancer and thromboembolic disease is well known. This relationship is complex and in many, perhaps most, malignant diseases acts through multiple pathways. Increased tissue factor expression by endothelial cells, monocytes or macrophages has been implicated as one of these pathways. As well as being found in the circulating blood, tissue factor is also found in urine in a lipid-associated form. Although urinary tissue factor might be independent from that found in the circulation, its levels may reflect the status of peripheral blood monocyte activation. Thus, measurements of monocyte and/or urinary tissue factor may be of clinical significance, particularly in cancer, where levels could be valuable for diagnosis and monitoring progression.