Urinary tissue factor: A potential marker of malignant disease

Dr Bashir A. Lwaleed

Dr Bashir A. Lwaleed, MDR Research Group, Departments of Urology/Surgery, Mail point 816, Level F, Central Block, Southampton University Hospitals NHT Trust, Tremona Road, Southampton, SO16 6YD ENGLAND Tel: +44 0 2380 796580 Fax: +44 0 2380 794020

Background: Abnormalities in laboratory coagulation and fibrinolysis parameters can be detected in cancer patients and tissue factor (TF) is implicated. TF is produced by certain tumours and is increased in both tumour-associated macrophages and blood monocytes (mTF). TF is also found in urine (uTF) and its levels may be clinically important. Patients and Method: 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 sub-divided into inflammatory, and non-inflammatory categories. Results: The controls and benign non-inflammatory 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:- for bladder 74.4%, prostate 68.0%, breast 77.3% and colorectal disease 73.0%. uTF levels were related to tumour 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. Conclusion: uTF levels are raised in malignant and inflammatory disease compared to controls and patients with non-inflammatory conditions. uTF levels are related to tumour grade or stage, patients' survival and to markers of tumour progression.

Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Prognostic Markers.