The activation of coagulation and fibrinolytic pathways is well recognized in patients with malignant disease including those with carcinoma of the pancreas. The elaboration of activators and inhibitors of coagulation and of fibrinolysis has been assessed in 8 human pancreatic adenocarcinoma cell lines in vitro. Tissue factor (TF) was commonly synthesized with wide variations in the amount produced between cell lines, whereas its inhibitor (tissue factor pathway inhibitor, TFPI) showed lower but more consistent levels. Of the activators of fibrinolysis, urokinase was produced by all but one cell line, whereas tissue plasminogen activator expression was much less frequently seen. A correlation between low TF or high TFPI and cell doubling time was demonstrated. These data suggest a complex interaction of tumour-derived enzymes capable of interacting with most haemostatic mechanisms.

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