Expression of tissue factor in pancreatic adenocarcinoma is associated with activation of coagulation

AIM： To study expression of tissue factor （TF） in pancreatic cancer and its role in the development of thromboembolism.METHODS： TF expression was studied in eight human pancreatic carcinoma cell lines by Northern blot and indirect immunofluorescence. Expression of alternatively spliced TF （asTF） was assessed by RT-PCR. In addition, TF expression was determined by immunofluorescence in pancreatic tissues of 19 patients with pancreatic adenocarcinoma （PCa）, 9 patients with chronic pancreatitis （CP） and 20 normal controls. Plasma samples （30 PCa-patients, 13 CP-patients and 20 controls） were investigated for soluble TF levels and coagulation activation markers [thrombin-antithrombin Ⅲ complex （TAT）, prothrombin fragment 1 ＋ 2 （F1 ＋ 2）]. RESULTS： All pancreatic carcinoma cell lines expressed TF （8/8） and most of them expressed asTF （6/8）. TF expression at the protein level did not correlate with the differentiation of the carcinoma cell line. All but two pancreatic cancer tissue samples stained positive for TF （17/19）. In all samples of CP weak staining was restricted to pancreatic duct cells, whereas only a few subendothelial cells were positive in 9/20 of normal controls. TF and TAT levels in PCa patients were significantly elevated compared to controls whereas elevated F1 ＋ 2 levels did not reach statistical significance compared to controls. In CP patients TAT and F1 ＋ 2 levels proved to be significantly elevated compared to controls, although TAT elevation was less pronounced than in PCa patients. CONCLUSION： We conclude that in addition to the upregulated expression of TF on the cell membrane, soluble TF might contribute to activation of the coagulation system in pancreatic cancer.

Rare pulmonary and cerebral complications after transarterial chemoembolisation for hepatocellular carcinoma:A case report

We report a rare case of acute pulmonary and cerebral complication after transarterial chemoembolisation (TACE) for inoperable hepatocellular carcinoma. The case involved a large tumor and hepatic vein invasion. Nonspecific pulmonary and cerebral symptoms such as acute dyspnoea and transient consciousness loss developed in the patient, a 49-year-old woman, following the TACE due to pulmonary and cerebral oil embolism. The chest and brain conditions of this patient improved after some supportive therapies and nursing interventions. She also subsequently completed the other three procedures of TACE.

Cerebral and pulmonary embolisms after transcatheter arterial chemoembolization for hepatocellular carcinoma

A cerebral lipiodol embolism is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma. We present a case of cerebral lipiodol embolism that occurred after the third arterial chemoembolization, report the clinical and radiological findings, and review the medical literature.

Embolization of an unusual metastatic site of hepatocellular carcinoma in the humerus

Hepatocellular carcinoma （HCC） is the fish most common cancer in the world. This case documents an unusual metastatic presentation of HCC in the humerus. Preoperative palliative arterial embolization of the tumor was performed to arrest severe tumor bleeding caused by the biopsy. Embolization turned out to be useful also in limiting/preventing potential uncontrolled bleeding during subsequent amputation.

Gadofullerene nanoparticles extend survival rate and down-regulate thrombin expression in orthotopic pancreatic cancer

Pancreatic cancer is a devastating malignant disease with 5-year survival rate less than 8%.The impenetrable desmoplastic stroma of pancreatic tissue and serious side-effects of existing drugs hinder the effective treatment for pancreatic carcinoma.Thus,it is imperative to exploit much more safe and efficient methods to prolong the survival of pancreatic cancer patients.In this study,we explored a superior anti-pancreatic cancer strategy based on gadofullerene nanoparticles(GFNPs)using an orthotopic human pancreatic carcinoma(PANC-1)tumor model.It was demonstrated that GFNPs could efficiently suppress orthotopic pancreatic cancer in a dose manner,and significantly extend the survival rate of tumor-bearing mice.Of note,the proteomic profiling of tumor tissues revealed that GFNPs ameliorated the coagulation cascade dysfunction and downregulated the thrombin expression in pancreatic tumor tissues.The regulation of abnormal thrombin by GFNPs was validated in vitro and in vivo.More importantly,GFNPs suppressed orthotopic pancreatic cancer with negligible adverse effects,superior to the widely recognized clinical antipancreatic cancer drug,gemcitabine.Together,this study provides a promising therapeutic for intractable pancreatic cancer as well as a potential to alleviate the cancer-associated thromboembolic diseases.