Urinary tissue factor levels in prostatic carcinoma: a potential marker of metastatic spread?

Recent investigations have suggested that levels of urinary tissue factor (UTF) may be elevated in some forms of cancer. We have determined UTF levels in healthy controls, patients presenting for surgery with benign prostatic hypertrophy (BPH) and untreated prostate cancer. Patients undergoing check cystoscopy, who were free of recurrent bladder cancer, and a cohort of men with bone scan positive prostate cancer recently treated by androgen ablation were also studied. UTF levels were higher in patients with prostate cancer when compared with controls, those undergoing check cystoscopy and patients with BPH. In patients with prostate cancer, bone scan positive patients had higher levels than bone scan negative subjects. The androgen ablated group had UTF levels similar to those of the control groups and significantly lower than the bone scan positive group. A weak correlation was found between UTF and serum prostate specific antigen (PSA) levels when patients with BPH and untreated cancer were analysed, but no correlation was demonstrable between PSA and UTF when cancer patients alone were evaluated. It was concluded that UTF levels are elevated in untreated prostate cancer and reflect bone scan status. In patients with bone scan positive disease UTF also reflects disease activity and may therefore be a useful disease marker in prostate cancer.