Ferrari E, Benhamou M, Berkane N, Baudouy M
Hôpital Pasteur, CHU, service de cardiologie, 30, avenue de la Voie romaine, 06002 Nice.
Arch Mal Coeur Vaiss. 2001 Nov;94(11 Suppl):1307-12.
Malignant disease predisposes to deep venous thrombosis (DVT) or pulmonary embolism (PE) in several ways. One classical situation is that of DVT or PE with no apparent cause which may be the first sign of an occult cancer. In this domain, although the epidemiological data is well known, it is important to recognise the limitations of "blind" investigations. Another situation is more common. The patients have a diagnosed malignancy and thromboembolic disease is the main extra-cancer complication. The approach to this problem is changing, both in primary prevention where many trials have already reported encouraging results, and in the treatment after the event where classical therapeutic protocols are not always well adapted. Ancestral fears of the prescription of anticoagulants in cancer patients must cede to a more objective benefit/risk analysis which seems to be very favourable in some situations. Moreover, some publications have demonstrated a chance finding of a possible anticancer effect of antithrombotic agents.
恶性疾病通过多种方式易引发深静脉血栓形成(DVT)或肺栓塞(PE)。一种典型情况是无明显诱因的DVT或PE,这可能是隐匿性癌症的首个迹象。在这方面,尽管流行病学数据广为人知,但认识到“盲目”调查的局限性很重要。另一种情况更为常见。患者已确诊患有恶性肿瘤,血栓栓塞性疾病是主要的癌症外并发症。对于这个问题的处理方法正在发生变化,在一级预防方面,许多试验已经报告了令人鼓舞的结果,而在事件发生后的治疗方面,传统的治疗方案并不总是非常适用。癌症患者对抗凝剂处方的传统担忧必须让位于更客观的获益/风险分析,在某些情况下,这种分析似乎非常有利。此外,一些出版物已经证明偶然发现了抗血栓药物可能具有的抗癌作用。