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    Poster Networking

    Hemostatic Systems in Cancer, Inflammation and Immunity

    Poster Networking Session

    PB0713 - Increased tissue factor mRNA expression is associated with high plasma levels of activated factor VII–antithrombin complex and predicts mortality in primary liver cancer

    Monday, June 26, 2023
    18:30 – 19:30 ET
    Room: Exhibition
    Background: Tissue factor (TF) is the main initiator of the coagulation cascade and has been shown to play a role in cancer physiopathology. Activated factor VII-antithrombin complex (FVIIa-AT) is considered an indirect marker of TF exposure by reflecting TF-FVIIa interaction.

    Aims: To assess the potential link between TF gene expression and FVIIa-AT plasma levels in primary liver cancer.

    Methods: TF gene expression analysis was performed by Real-Time RT-PCR in 91 patients with primary liver cancer (51 hepatocellular carcinoma and 40 cholangiocarcinoma) undergoing surgical intervention with a curative intent. The analysis was performed by comparing TF gene expression levels in neoplastic versus homologous non-neoplastic liver tissues. Data of FVIIa-AT plasma levels were available for all these subjects.

    Results: Considering TF gene downregulated when fold change < 1 or upregulated when fold change >1, 49 cancer tissues showed TF downregulation, while 42 cancer tissues had TF upregulation as compared to homologous non-neoplastic liver tissue. Subjects with cancer tissues showing TF upregulation had marginally higher FVIIa-AT plasma levels. Stratifying the study cohort according to FVIIa-AT plasma concentration, the proportion of subjects with induced TF gene increased progressively from the lowest to the highest quartile (33.3%-->71.4%, P=0.037 by χ2 for linear trend). Considering overall survival in the study cohort after a 34-month median follow-up, Kaplan-Meier survival curves showed an increased mortality rate in patients with TF upregulation as compared to those with TF downregulation (54.8% versus 36.7%, P=0.036 by log-rank test). TF upregulation in cancer tissue was associated with an about two-fold increased risk of mortality (HR=1.98, 95%CI 1.04-3.77, P=0.038) after adjustment for sex, age, and creatinine levels.

    Conclusion(s): Increased TF gene expression was associated with both high FVIIa-AT plasma levels and an increased risk of mortality in patients with primary liver cancer. The evaluation of FVIIa-AT plasma levels may allow to identify patients with highly TF-expressing cancer.