EVALUATION OF HEPARANASE PROCOAGULANT ACTIVITY AND TISSUE FACTOR PATHWAY INHIBITOR LEVEL IN OVARIAN CANCER PATIENTS

Abstract

IntroductionOvarian cancer is considered one of the most common malignancies in females worldwide. Early detection of ovarian cancer will provide the patient with better chance of survival while discovering the disease at late stage will significantly increase the morbidity and the risk of complications. Hemostasis is a complex physiological process and to achieve normal hemostasis, delicate balance between clotting cascade and fibrinolytic cascade is required to prevent thrombosis or hemorrhage. Heparanase is an endoglycosidase enzyme which cleaves heparane sulphate, it is expressed in human tumors. Heparanase upregulation correlates with increased tumor vascularity and poor postoperative survival of cancer patients so heparanase is implicated in angiogenesis and tumor progression. It is now well established that the prime trigger to blood coagulation is tissue factor (TF) that is exposed on the surface of fibroblasts as a result of vessel wall injury. TFPI binds to factor Xa and, in this combination, binds to and inhibits tissue factor / factor VIIa complex and activated FX (FXa) and thus TFPI is currently being included as a natural coagulation inhibitor.Aim of the workThe aim of this work was to investigate the relation of both heparanase procoagulant activity and tissue factor pathway inhibitor level with thromboembolic complications and metastasis in ovarian cancer patients.