Mona Abu El-Makarem1, Atef El-Akad1, Moustafa Elian2, Tahra Sherif3, Ragaa El-Shaheed1, Aliaa Abd El Fatah1, Douaa Sayed4, Rania Bakry4, Aisha Mahmoud1. 1. Department of Internal Medicine, School of Medicine, Minia University, Minia, Egypt. 2. Department of Radio-Diagnosis, School of Medicine, Minia University, Minia, Egypt. 3. Department of Clinical Pathology, School of Medicine, Assuit University, Assuit, Egypt. 4. Department of Clinical Pathology, South Egypt Cancer Institute, Assuit University, Assuit, Egypt.
Abstract
BACKGROUND AND AIMS: Portal vein thrombosis (PVT) is a critical complication in cirrhotic patients. We explored the role of the activated factor VII-antithrombin (FVIIa-AT) complex and enhanced monocytic tissue factor (TF) expression in the development and prediction of non-neoplastic PVT in cirrhotic patients. MATERIAL AND METHODS: A total of 30 HCV-cirrhosis patients were included in our study. They were compared to 35 cirrhotic patients without PVT, 15 non-cirrhotic patients with PVT, and 15 healthy controls. The plasma level of the FVIIa-AT complexes was analyzed by ELISA. MIF CD142, CD86, and HLA-DR on monocytes (CD14) were determined by flow cytometry. RESULTS: Compared with cirrhotic patients without PVT, cirrhotic patients with PVT had comparable plasma values of FVIIa, AT, and the FVIIa-AT complex. However, they had significantly lower values compared to non-cirrhotic patients with PVT and healthy controls. Cirrhotic patients with PVT had increased monocytic TF expression (MIF CD142) compared to non-PVT cirrhotic patients and healthy controls [86.5 (93.5) vs. 18 (32.0) and 11.0 (6.0), respectively; p < 0.001 for each]. However, cirrhosis PVT could not be distinguished from non-cirrhosis PVT. The area under the ROC curve of MIF CD142 was 0.759 (0.641- 0.876; p = 0.000) at an optimal cut-off value of 45, which yielded a sensitivity of 60% and a specificity of 77.1%, as well as a PPV and NPV of 69.2% for each. CONCLUSION: Enhanced expression of monocytic TF may have a role in the development and prediction of non-neoplastic PVT in HCV-cirrhosis patients. Large multicenter studies are necessary to validate our results.
BACKGROUND AND AIMS: Portal vein thrombosis (PVT) is a critical complication in cirrhoticpatients. We explored the role of the activated factor VII-antithrombin (FVIIa-AT) complex and enhanced monocytic tissue factor (TF) expression in the development and prediction of non-neoplastic PVT in cirrhoticpatients. MATERIAL AND METHODS: A total of 30 HCV-cirrhosispatients were included in our study. They were compared to 35 cirrhoticpatients without PVT, 15 non-cirrhoticpatients with PVT, and 15 healthy controls. The plasma level of the FVIIa-AT complexes was analyzed by ELISA. MIFCD142, CD86, and HLA-DR on monocytes (CD14) were determined by flow cytometry. RESULTS: Compared with cirrhoticpatients without PVT, cirrhoticpatients with PVT had comparable plasma values of FVIIa, AT, and the FVIIa-AT complex. However, they had significantly lower values compared to non-cirrhoticpatients with PVT and healthy controls. Cirrhoticpatients with PVT had increased monocytic TF expression (MIFCD142) compared to non-PVT cirrhoticpatients and healthy controls [86.5 (93.5) vs. 18 (32.0) and 11.0 (6.0), respectively; p < 0.001 for each]. However, cirrhosis PVT could not be distinguished from non-cirrhosis PVT. The area under the ROC curve of MIFCD142 was 0.759 (0.641- 0.876; p = 0.000) at an optimal cut-off value of 45, which yielded a sensitivity of 60% and a specificity of 77.1%, as well as a PPV and NPV of 69.2% for each. CONCLUSION: Enhanced expression of monocytic TF may have a role in the development and prediction of non-neoplastic PVT in HCV-cirrhosispatients. Large multicenter studies are necessary to validate our results.