The Study Of The Correlation Between The Expression Of TF, TFPI And Haematological Malignancies

Background Recently, it has been recognized that the patients with malignant tumors may have associated thrombotic disorders, and the cytokines participating in the blood coagulation cascade frequently have aberrant expression. As one of the most potent agglutinants, tissue factor (TF) may have overexpression in many types of tumors, which may be directly related to the biology of the diseases, and contributes to tumorigenesis and progression. Whereas, tissue factor pathway inhibitor (TFPI) is the only known physiological component which can inhibit the activity of TF. The plasma expression levels of TF and TFPI in haematological malignancies, and its relationship with clinical course of the diseases have been paid more attention in recent years.Objective To examine the expression of TF and TFPI in patients with haematological malignancies, and explore their relationships with those diseases.Methods The expression and change of TF and TFPI were detected in the peripheral venous blood samples from 20 normal controls, and 78 patients with haematological malignancies—34 patients with acute leukemia (AL), 12 with chronic myeloblastic leukemia (CML), 12 with non-Hodgkin lymphoma (NHL), 7 with multiple myeloma (MM), 6 with myeloproliferative disorders (MPD), and 7 with myelodysplastic syndrome (MDS), by enzyme linked immunosorbent assay (ELISA). After that, the correlation of TF and TFPI were analyzed.Results The levels of TF were significantly higher in haematological malignancies, except MDS. Compared to patients with CML chronic phase (CML, CP) and normal control, patients in CML blastic crisis (CML, BC) and in accelerated phase (CML, AP) had higher median TF and TFPI. The levels of TF and TFPI were significantly higher in acute promyelocytic leukemia(APL) than those in patients with AL, except APL. In the remission group, the expression of TF and TFPI in patients with AL,NHL and MM after treatment was obviously higher than that of patients before treatment. The patients who failed in remission before treatment had significantly higher median TF than those who reached remission. In APL, the levels of TF and TFPI before treatment were significantly higher than those after treatment. The TF, TFPI levels in recurrence group before treatment were higher than those in newly diagnostic group. The expression of TF from patients with disseminated intravascular coagulation (DIC) was significantly higher than those in patients without DIC. In DIC group, the levels of TF and TFPI before treatment were significantly higher than those after treatment.Conclusions In haematological malignancies, there was a correlation between the expression of TF and the malignant degree and the possibility of remission, which could be one of the markers of disease staging, curative effects and prognosis. In certain degree, the expression of TFPI reflects the development of diseases. There was a correlation between the expression of TF and DIC. TF and TFPI levels might be useful for the prediction of the curative effects of DIC.