Thrombosis is a common complication in the clinical course of cancer. Vascular endothelial cells and/or the hemostatic-coagulatory system are thought to play important roles in cancer-related thrombosis (CRT). Additionally, several new cancer drugs increase risk of therapy-related thrombosis. Extracellular vesicles (EVs) are small membrane vesicles that are released from many different cell types via exocytic budding of the plasma membrane in response to cellular activation or apoptosis. The merits of detecting tissue factor-expressing EVs in cancer patients make EVs an important feature in current clinical applications. We assessed 240 cancer patients for endothelial cell-derived EVs (EDEVs) and thrombosis-related biomarkers. Among the 240 patients, 23 had CRT within 6 months after their first examination. Plasma concentrations of EDEVs, and soluble endothelial protein C receptor (sEPCR), high mobility group box protein 1 (HMGB1) and plasminogen activator inhibitor-1 (PAI-1) were higher in cancer patients than healthy controls. Additionally, the elevated EDEVs in CRT patients were significantly higher than those in non-CRT patients. Finally, the levels of EDEVs, and soluble EPCR and HMGB1 were negatively correlated with survival times; in particular, EDEV levels were significantly lower in patients who lived for more than 901 days after their first examination compared with previous data. These results suggested that EDEVs are associated with the hypercoagulable state of cancer patients, and that the elevated risk of thrombosis conferred by hypercoagulability could be predicted by measuring serum EDEVs.
View Full Article