Data detailed in “Tissue factor expression, angiogenesis, and thrombosis in pancreatic cancer” have been presented. “Hemostatic activation is common in pancreatic cancer and may be linked to angiogenesis and venous thromboembolism. We investigated expression of tissue factor (TF), the prime initiator of coagulation, in noninvasive and invasive pancreatic neoplasia,” investigators in the United States report.
“We correlated TF expression with vascular endothelial growth factor (VEGF) expression, microvessel density, and venous thromboembolism in resected pancreatic cancer. Tissue cores from a tri-institutional retrospective series of patients were used to build tissue microarrays. TF expression was graded semiquantitatively using immunohistochemistry in normal pancreas (n=10), intraductal papillary mucinous neoplasms (n=70), pancreatic intraepithelial neoplasia (n=40), and resected or metastatic pancreatic adenocarcinomas (n=130). TF expression was observed in a majority of noninvasive and invasive pancreatic neoplasia, including 77% of pancreatic intraepithelial neoplasias, 91% of intraductal papillary mucinous neoplasms, and 89% of pancreatic cancers, but not in normal pancreas. Sixty-six of 122 resected pancreatic cancers (54%) were found to have high TF expression (defined as grade >or=2, the median score). Carcinomas with high TF expression were more likely to also express VEGF (80% versus 27% with low TF expression, p<0.0001) and had a higher median MVD (8 versus 5 per tissue core with low TF expression, p=0.01). Pancreatic cancer patients with high TF expression had a venous thromboembolism rate of 26.3% compared with 4.5% in patients with low TF expression (p=0.04). TF expression occurs early in pancreatic neoplastic transformation and is associated with VEGF expression, increased microvessel density, and possibly clinical venous thromboembolism in pancreatic cancer,” wrote A.A. Khorana and colleagues, University of Rochester, Department of Medicine.

The researchers concluded: “Prospective studies evaluating the role of TF in pancreatic cancer outcomes are warranted.”

Khorana and colleagues published their study in Clinical Cancer Research (Tissue factor expression, angiogenesis, and thrombosis in pancreatic cancer. Clinical Cancer Research, 2007;13(10):2870-5).

For additional information, contact A.A. Khorana, University of Rochester, University of Rochester, Dept. of Medicine, Rochester, New York 14642 USA.

The publisher of the journal Clinical Cancer Research can be contacted at: American Association Cancer Research, 615 Chestnut St., 17TH Floor, Philadelphia, PA 19106-4404, USA.