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(Chest. 2003;124:58S-68S.)
© 2003 American College of Chest Physicians

Tissue Factor, Thrombin, and Cancer*

Frederick R. Rickles, MD; Steven Patierno, PhD and Patricia M. Fernandez, PhD

* From the Departments of Medicine, Pediatrics, Pharmacology, and Urology, The George Washington University, Washington, DC.

Correspondence to: Frederick R. Rickles, MD, Executive Director, Federation of American Societies for Experimental Biology, 9650 Rockville Pike, Bethesda, MD 20814-3998

In addition to its primary role in hemostasis and blood coagulation, thrombin is a potent mitogen capable of inducing cellular functions. Therefore, it should come as no surprise that thrombin has proved to be of importance in the behavior of cancer. In this review, we focus on the ability of tissue factor (TF) and thrombin to influence tumor angiogenesis. Both exert their influence on angiogenesis through clotting-dependent and clotting-independent mechanisms: (1) directly affecting signaling pathways that mediate cell functions, and (2) mediating clot formation, thereby providing a growth media for tumor cells. Therefore, anticoagulant drugs may prove efficacious in cancer treatment due to their ability to reduce the characteristic hypercoagulability of cancer and alter the fundamental biology of cancer.

Key Words: angiogenesis • cancer • fibrinogen • thrombosis • tissue factor




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