Artikel
Expression and up-regulation of coagulation factors and their receptors in tumor tissue and peripheral blood of patients with cerebral meningiomas
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Autoren
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S. Kuhn
- Neurochirurgische Klinik, Klinikum der Friedrich-Schiller-Universität, Jena, Deutschland
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L. Handel
- Neurochirurgische Klinik, Klinikum der Friedrich-Schiller-Universität, Jena, Deutschland
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R. Kalff
- Neurochirurgische Klinik, Klinikum der Friedrich-Schiller-Universität, Jena, Deutschland
| Veröffentlicht: | 28. April 2011 |
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Gliederung
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Objective: Patients with meningiomas may suffer from thrombembolic complications or bleeding into the tumor resection cavity. Clear reasons for these complications are not known to date.
Methods: Twenty tumor samples of intracranial meningiomas each (WHO I°, WHO II°, and WHO III°) were analyzed immunohistochemically for the expression of the coagulation factors II/IIa and X/Xa as well as for the expression of the protease-activated receptors type 1, 2, 3, and 4. In addition, patients with intracranial meningiomas WHO I° and WHO II° were included in a prospective case-controlled study and correlated to control patients with lumbar disc herniations. Their blood was collected one day before and one and four days after tumor surgery and investigated for the activity of the coagulation factors II, V, VII, VIII, IX, X, XI, XII and XIII, as well as for the activity of antithrombin III, and the concentrations of the d-dimers and of fibrinogen.
Results: Human meningiomas displayed tumor-specific expression patterns of coagulation factors and their receptors when compared to the formerly collected expression data of human gliomas or brain metastases. Whereas the PAR1 and PAR2 were found at low levels, PAR3 and PAR4 were strongly expressed in human meningiomas, even rising with the WHO grade. Prothrombin and thrombin were also expressed in meningioma cells and are known for different actions at the PARs 3 and 4 in comparison to the PARs 1 and 2. In addition, patients with intracranial meningiomas show an up-regulation of the coagulation factors II and IX and a down-regulation of the coagulation factor XIII in their peripheral blood.
Conclusions: This study shows the different expression patterns of coagulation factors and their receptors in human meningiomas and the distinct activation and inactivation patterns of the peripheral coagulation factors II, IX, and XIII. Patients with thrombembolic events may often display an activation of the factors II and IX, whereas patients with intratumoral or postoperative bleeding may have reduced factor XIII levels.
