Urinary tissue factor levels in neoplastic diseases

Abnormalities in laboratory coagulation and fibrinolysis parameters can be detected in cancer patients, and tissue factor (TF) is implicated. TF is produced by certain tumors and is increased in both tumor associated macrophages and blood monocytes (mTF). TF is also found in urine (uTF), and its levels may be clinically important.

Using a simple and highly standardized kinetic chromogenic assay (KCA), we measured uTF levels in controls (normal, n=57; patients with renal stones, n=30), patients with benign and malignant conditions of the bladder (n=75), prostate (n=106), breast (n=94), and colorectum (n=62). Each benign disease group was subdivided into inflammatory and noninflammatory categories.

The controls and benign noninflammatory groups gave similar results and were, therefore, unified for further analysis. The malignant and inflammatory groups showed higher uTF levels than the controls (P<0.001 for bladder, P<0.01 prostate, P<0.001 breast, and P<0.001 for colorectum). The difference between malignant and benign inflammatory disease was significant for the bladder group (P<0.05). Cancer patients showed uTF activity above the upper quartile range of the normal control group--74.4% for bladder, 68.0% for prostate, 77.3% for breast and 73.0% for colorectal disease. uTF levels were related to tumor progression, patients survival time, serum prostate specific antigen (PSA), and static bone scan images (SBSI). Levels were also higher in patients with bladder cancer recurrence and those who subsequently died.

uTF levels are raised in malignant and inflammatory disease compared to controls and patients with noninflammatory conditions, and are related to tumor grade or stage, patients survival and to markers of tumor progression.