Plasma tissue factor concentration in liver cirrhosis and hepatocellular carcinoma

Kim, Ji Young; Seo, Soo Boon; Park, Chan Won; Lee, Dong Hyun; Ju, Hyung Joon; Kang, Dae Hwan; Cho, Mong; Yang, Ung Suk

Abstract

BACKGROUND
Tissue factor (TF) is a main physiological initiator of blood coagulation and may be important in the biology of a variety of solid malignancies, particularly where angiogenesis is a critical factor. In liver cirrhosis, hyperfibrinolysis is frequently observed in patients with the decompensated state and which may be secondary to the increased production of thrombin. Many studies have shown that the expression of TF in tumors contributes not only to tumor-derived procoagulant activity but also to hematogenous metastasis and tumor angiogenesis. The aim of this study was to evaluate how plasma TF concentration was correlated with the severity of liver cirrhosis and the progression of hepatocellular carcinoma.
METHODS
This study consisted of 23 patients with liver cirrhosis (LC) and 37 patients with hepatocellular carcinoma (HCC). HCC patients was graded by TNM staging system of The Union Internationale Contre le Cancer (UICC). Plasma TF concentration was measured by the enzyme linked immunosorbent assay (ELISA). The severity of the liver disease was estimated by Child-Pugh classification. The correlation of TF concentration in patients with LC and HCC in diffenrent classifications was evaluated.
RESULTS
There was no difference between LC and HCC in the plasma TF concentration (p=0.236). The TF concentration was different according to Child-Pugh score (p=0.024) and proportion to Child-Pugh score in class B and C (p<0.05). The TF concentration of HCC patients was not different between the classes of severity of underlying LC and the TF concentration of stage IVA was higher than that of stage I, II, III in HCC patients (p=0.039).
CONCLUSION
The plasma concentration of TF was correlated with the degree of severity of liver disease in cirrhotic patients and increased in the advanced stages of HCC.