Tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in the peritoneal fluid in patients with peritonitis – is the key towards intraperitoneal adhesions and complications?

Abstract

Abstract Introduction The concentrations of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in the peritoneal fluid and blood plasma in patients with peritonitis were examined. The fibrinogenesis of the peritoneal cavity is not well-known although it is regarded as the main cause of intraperitoneal adhesions and the complications that arise from this. Materials and methods The study enrolled a group of 77 consecutive patients with peritonitis, 28 women and 49 men aged 18–79 years (with an average age of 45 ±18 years). The patients were divided into 2 subgroups: those with complications (n = 64) and those without (n = 13). Concentrations of TF and TFPI in the peritoneal fluid and blood plasma of patients were examined. Results In the peritoneal fluid, patients with complications had a higher concentration of TF (p < 0.007), but a lower concentration of TFPI (p < 0.0006). In blood plasma, TF was higher but TFPI was lower (p < 0.00001 in both). The area under curve (AUC) for TF and TFPI was 0.763 and 0.93 respectively, the cut-off point was 809.08 pg/mL and 21.6 pg/mL, respectively. The positive predictive value (PPV) and negative predictive value (NPV) for TF was 68% and 75% and for TFPI, 80% and 85%, respectively. Conclusions The data can be taken as an example of cross-linking between extravascular coagulation and intraperitoneal adhesions. On the basis of TF and TFPI, it is clearly illustrated that there is some connection between coagulation and peritoneal fibrinogenesis, which could be involved in the pathogenesis of many complications in abdominal surgery and also indicate therapeutic targets.