ROLE OF TNF AND IL-1 IN PATHOPHYSIOLOGY AND HOST-DEFENCE MECHANISM IN PATIETNTS WITH PROSTATE CANCER

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The present study was undertaken to evaluate the relationship between serum tumor necrosis factor (TNF) and coagulopathy and cachexia in patients with prostate cancer. TNF levels were determined in 110 serum samples from prostate cancer patients by an enzyme immunoassay. Serum TNF activity was positive in 76% of the patients with relapsed disease, whereas only 11% of the untreated patients and 0% of the patients in remission as a result of endocrine therapy were positive. Serum levels of fibrin/fibrinogen degradation product E fragment (FDP) and plasma levels of fibrin degradation product D-dimer (D-dimer), thrombin-antithrombin-III complex (TAT) and plasmin-a2-antiplasmin inhibitor complex (PIC) in patients with elevated serum TNF levels were significantly higher than those in patients with undetectable serum TNF levels. Patients with coagulopathy had a significant increase in serum TNF levels. The serum total protein and albumin levels, hemoglobin levels, and body mass index and performance status of the patients with elevated serum TNF levels were significantly impaired than the corresponding values in patients with undetectable serum TNF levels. Patients with elevated serum TNF levels had a significantly higher mortality rate than those with undetectable serum TNF levels. Patients with cachexia showed a significant increase in serum TNF levels than patients without cachexia. These findings suggest that TNF may be one of the factors contributing to the coagulopathy and complex syndrome of cachexia in patients with prostate cancer.