Korean J Clin Oncol.  2018 Dec;14(2):128-134. 10.14216/kjco.18022.

Tissue factor expression is associated with recurrence in patients with non-metastatic colorectal cancer

• Jung HJ
• Kim HJ
• Kaneko K
• Kazama Y
• Kawai K
• Ishihara S
• Choi GS

• KMID: 2432611
• DOI: http://doi.org/10.14216/kjco.18022

Abstract

PURPOSE
Previous studies have addressed the role of the hypercoagulable state in the pathogenesis of cancer progression and metastasis. In this study, we investigated the association between coagulation factors, including tissue factor (TF) expression, platelet count, and fibrinogen level, and disease recurrence in patients with non-metastatic colorectal cancer.
METHODS
Patients who underwent curative resection for stage II or III colorectal cancer between 2000 and 2007 were included in this study. Data from a prospectively maintained database were retrospectively reviewed. TF expression was determined by immunohistochemistry using an anti-TF monoclonal antibody. The Kaplan-Meier method was used to estimate 5-year disease-free survival.
RESULTS
TF was highly expressed in 257 of 297 patients (86.5%). TF expression was not significantly associated with the platelet counts (P=0.180) or fibrinogen level (P=0.281). The 5-year disease-free survival rate was lower in patients with high TF expression than in patients with low TF expression (72.3% vs. 83.9%, P=0.074). In Cox hazard analysis, high TF expression was an independent risk factor for tumor recurrence (hazard ratio [HR] 2.446; 95% confidence interval [CI], 1.054-5.674; P=0.037). Undifferentiated histologic type (HR, 2.911; 95% CI, 1.308-6.481; P=0.009), venous invasion (HR, 2.784; 95% CI, 1.431-5.417; P=0.003), and lymph node metastasis (HR, 2.497; 95% CI, 1.499-4.158; P < 0.001), were also significantly associated with disease recurrence.
CONCLUSION
TF expression is associated with a recurrence in patients with non-metastatic colorectal cancer. However, further studies are required to clarify the underlying mechanisms relating TF expression with oncologic outcomes and its potential role as a therapeutic target.

Keyword

Colonic neoplasms; Prognosis; Survival; Immunohistochemistry

MeSH Terms

Blood Coagulation Factors
Colonic Neoplasms
Colorectal Neoplasms*
Disease-Free Survival
Fibrinogen
Humans
Immunohistochemistry
Lymph Nodes
Methods
Neoplasm Metastasis
Platelet Count
Prognosis
Prospective Studies
Recurrence*
Retrospective Studies
Risk Factors
Thromboplastin*
Blood Coagulation Factors
Fibrinogen
Thromboplastin