Abstract Number: PB1780
Meeting: ISTH 2020 Congress
Background: Tissue factor (TF), the main initiator of the coagulation cascade, plays a role in cancer progression. In preliminary analysis we showed that plasma concentration of activated factor FVII-antithrombin (FVIIa-AT), a biomarker reflecting FVIIa-TF interaction, may predict mortality in patients with liver and colon cancer.
Aims: To examine more in depth the potential prognostic role of FVIIa-AT by evaluating other hemostatic biomarkers related to FVIIa-TF pathway in a cohort of subjects with liver and colon cancer undergoing surgical intervention with a curative intent.
Methods: Out of the original study cohort of 138 neoplastic patients assessed for FVIIa-AT levels, plasma samples for FVII antigen (FVII_Ag), total and free tissue factor pathway inhibitor (TFPI) assays were available for 137 subjects (67.2% males, mean age 67.4±9.6 years, 37.2% hepatocellular carcinoma, 31.4% cholangiocarcinoma, and 31.4% colon cancer). Samples of venous blood were drawn before surgery. FVIIa-AT, FVII_Ag, total and free TFPI levels were measured by ELISA.
Results: FVIIa-AT, FVII_Ag, total and free TFPI plasma levels were all reciprocally directly correlated. After a 34-month median follow-up, 75 subjects (54.7%) died. Stratifying the study population according plasma concentration of these hemostatic biomarkers, mortality rate increased progressively from the lowest to the highest quartile of FVIIa-AT (38.2%à54.3%à54.3%à70.6%, P=0.003) and total TFPI (35.3%à61.8%à51.4%à70.6%, P=0.023), while no significant association was found for either free TFPI or FVII_Ag. The association of FVIIa-AT and total TFPI with mortality was confirmed after adjustment for sex, age, and type of cancer. Including both FVIIa-AT and total TFPI in Cox regression models, only FVIIa-AT remained a predictor of mortality (the highest versus the lowest quartile: HR 2.95 with 95%CI 1.49-5.84), while the association was lost for total TFPI.
Conclusions: Plasma concentration of FVIIa-AT, rather than those of TFPI and FVII_Ag, may predict mortality in patients with liver and colon cancer undergoing curative surgical intervention.
To cite this abstract in AMA style:De Santis D, Castagna A, Moruzzi S, Udali S, Baroni M, Pattini P, Ruzzenente A, Conci S, Campagnaro T, Woodhams B, Van Dreden P, Guglielmi A, Bernardi F, Olivieri O, Friso S, Martinelli N. Plasma Concentration of Activated Factor VII-antithrombin, But Not Tissue Factor Pathway Inhibitor and Factor VII Levels, Predicts Mortality in Subjects with Liver and Colon Cancer Undergoing Curative Surgical Intervention [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/plasma-concentration-of-activated-factor-vii-antithrombin-but-not-tissue-factor-pathway-inhibitor-and-factor-vii-levels-predicts-mortality-in-subjects-with-liver-and-colon-cancer-undergoing-curative/. Accessed January 27, 2022.
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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/plasma-concentration-of-activated-factor-vii-antithrombin-but-not-tissue-factor-pathway-inhibitor-and-factor-vii-levels-predicts-mortality-in-subjects-with-liver-and-colon-cancer-undergoing-curative/