Toyoda Maki, Satoh Toyomi, Takano Katsumi, Sato Nakako Okada, Oki Akinori, Tsunoda Hajime, Yoshikawa Hiroyuki
Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan.
Int J Clin Oncol. 2005 Dec;10(6):444-6. doi: 10.1007/s10147-005-0517-6.
Patients with ovarian cancer with clear cell histology often have venous thromboembolism (VTE) even before surgery. In view of the possible association between clear cell histology and VTE in endometrial cancer, we measured the plasma levels of thrombin-antithrombin III complex (TAT) and D-dimer (DD) in the preoperative examinations of a patient with clear cell adenocarcinoma of the endometrium. Plasma TAT and DD were both highly elevated, though the patient had no symptoms of VTE or risk factors such as obesity or diabetes mellitus. Ultrasound Doppler examination and lung perfusion scintigraphy just before surgery revealed a thrombosis in the left popliteal vein and a pulmonary embolism. After implanting an inferior vena cava filter to prevent a fatal embolism of the lung, we performed abdominal total hysterectomy, bilateral salpingo-oophorectomy, and sampling of the pelvic lymph nodes. The VTE gradually disappeared and the plasma levels of TAT and DD returned to normal after surgery. Possibly, the VTE in this patient may have been associated with the clear cell histology.
具有透明细胞组织学特征的卵巢癌患者甚至在手术前就常常发生静脉血栓栓塞（VTE）。鉴于透明细胞组织学与子宫内膜癌中VTE之间可能存在关联，我们在一名子宫内膜透明细胞腺癌患者的术前检查中测量了凝血酶 - 抗凝血酶III复合物（TAT）和D - 二聚体（DD）的血浆水平。尽管该患者没有VTE症状或肥胖、糖尿病等风险因素，但血浆TAT和DD均显著升高。术前超声多普勒检查和肺灌注闪烁扫描显示左腘静脉血栓形成和肺栓塞。在植入下腔静脉滤器以预防致命的肺栓塞后，我们进行了腹式全子宫切除术、双侧输卵管卵巢切除术和盆腔淋巴结取样。术后VTE逐渐消失，TAT和DD的血浆水平恢复正常。该患者的VTE可能与透明细胞组织学有关。
