“…These include the release of cancer procoagulant [32,79] , downregulation of tissue factor pathway inhibitor (TFPI) [80][81][82][83] , upregulation of plasminogen activator inhibitor 1 (PAI-1), or cyclooxygenase 2 (COX-2) [84] , deregulation of the protein C system [85] and through a number of other scenarios [32] . At least in part, these procoagulant tendencies in cancer patients could be attributed to the prothrombotic conversion of cancer cells [32,86] , notably their increased levels of TF expression, as well as the elevation of TF found in circulating blood [31,32,45,75,77] . While cancer cells are known to shed TF-containing microparticles into the culture medium (in vitro) and into the bloodstream (in vivo) [32,57,87,88] , other sources of the circulating TF in cancer patients should also be considered, including platelets, monocytes and stromal cells [46,52,53,57,[89][90][91] .…”