Association between increased tumor necrosis factor alpha levels and acquired activated protein C resistance in patients with metastatic colorectal cancer.

International Journal of Colorectal Disease
Patrizia FerroniMario Roselli

Abstract

The purpose of this study was to investigate the possible association between tumor necrosis factor-α (TNF-α) levels and defects in the activated protein C (APC) system as a determinant of venous thromboembolism (VTE) in metastatic colorectal cancer patients (mCRC) undergoing chemotherapy. TNF-α levels (measured by immunoassay) and abnormalities in the APC system [evaluated by an APC-dependent thrombin generation assay (ThromboPath-ThP)] were evaluated in 45 mCRC patients undergoing chemotherapy. VTE events were recorded during follow-up. TNF-α levels were increased (p < 0.01), and APC functionality was decreased (p < 0.0001) in mCRC patients compared to age- and sex-matched controls. An inverse correlation was observed between TNF-α and APC impairment in mCRC (p < 0.0001). TNF-α was confirmed as an independent predictor (p = 0.007) for APC abnormalities at multivariate regression analysis. Nine (20 %) of 45 mCRC patients experienced VTE during chemotherapy. Bayesian analysis of combined ThP/TNF-α showed a positive predictive value of 0.67 in predicting VTE (p = 0.01). Cox proportional hazards survival analysis confirmed the predictive value of combined ThP/TNF-α determination in VTE risk assessment of mCRC patients (either neg...Continue Reading

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Citations

Jul 6, 2013·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Sang-Yeon SuhEunji Yim
Jul 16, 2013·Annals of Oncology : Official Journal of the European Society for Medical Oncology·M RoselliF Guadagni
Jan 27, 2016·Critical Reviews in Oncology/hematology·Amene Saghazadeh, Nima Rezaei
Feb 14, 2013·International Journal of Cancer. Journal International Du Cancer·Mario RoselliFiorella Guadagni
Feb 21, 2018·Investigational New Drugs·Jade K PollockDaniela M Zisterer
Jan 18, 2019·Cancers·Silvia RiondinoFiorella Guadagni
Jul 10, 2020·Translational Research : the Journal of Laboratory and Clinical Medicine·Ann S KimKeith R McCrae
Oct 15, 2020·Current Drug Targets·Lin ZhengJie Yao

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