Tissue factor assays as diagnostic tools for cancer? Correlation between urinary and monocyte tissue factor activity

Monocyte and urinary tissue factors (mTF and uTF) are both elevated in a nu mber of pathologic conditions, including cancer. This study validates the b est available uTF and mTF assays as diagnostic tools for cancer and examine s if uTF levels reflect monocyte activation, Using kinetic chromogenic assa ys for uTF and mTF (measured on fresh resting cells [baseline], unstimulate d cells, and lipopolysaccharide [LPS]-stimulated cells), we assessed TF lev els in normal individuals, surgical controls, and patients with benign and malignant diseases, Each benign disease group was stratified as inflammator y or noninflammatory, Controls and benign noninflammatory results were indi stinguishable. The malignant and inflammatory groups showed raised uTF leve ls over controls (p < 0.001). mTF levels differ similarly, For mTF and uTF assays, there was no significant difference between the malignant and infla mmatory groups, The relative operating characteristic (ROC) curve plots sen sitivity against false positive rate (l-specificity) for all possible cutof f values of a diagnostic test, Assay performance is assessed as the area un der the curve (AUC), The ROC curve for the uTF assay displayed both sensiti vity and specficity for cancer, the AUC being 0.83. Of the three mTF levels , UPS-stimulated cells gave the optimum curve (AUC = 0.71). uTF showed a we ak to moderate association with mTF levels but correlated best and was stat istically significant when compared with levels in the UPS-stimulated cells , uTF represents an intrinsic, kidney-derived, physiologic concentration ra ther than that of preactivated or postactivated monocytes, In conclusion, b oth uTF and UPS-stimulated mTF levels showed sensitivity and specificity in detecting cancer and inflammatory diseases, However, the two forms of TF a ppear to be independently derived.