Demirkan Binnaz, Ozcan Mehmet Ali, Glu Ahmet Alacacio, Yüksel Faize, Undar Bülent, Alakavuklar Mehmet
Dokuz Eylul University School of Medicine, Department of Internal Medicine, Division of Hematology-Oncology, Izmir, Turkey.
Clin Appl Thromb Hemost. 2006 Jan;12(1):9-14. doi: 10.1177/107602960601200103.
An increased incidence of thromboembolic events has been described in women receiving systemic chemotherapy for breast cancer. The effect of anthracycline-based adjuvant chemotherapy regimens on fibrinolytic system markers of plasminogen activator inhibitor-1 (PAI-1) and thrombin activitable fibrinolysis inhibitor (TAFI) was investigated in patients with operable breast cancer. Twenty-four patients with operable breast cancer (median age, 54.5 years; range, 37-72 years) enrolled in our study. Stage I-II and stage IIIA cases received EC (Epirubicin 90 mg/m(2)/d1, I.V. and cyclophosphamide 600 mg/m(2)/d1, I.V.) and FEC (5-fluorouracil 500 mg/m(2)/d1, I.V., epirubicin 100 mg/m(2)/d1, I.V., and cyclophosphamide 500 mg/m(2)/d1, I.V.) as an adjuvant chemotherapy regimen, respectively. Each group consisted of 12 patients. Blood samples were obtained at baseline and just before the third cycle of EC and fourth cycle of FEC chemotherapy regimens. Plasma TAFI antigen and PAI-1 levels did not disclose any statistical difference between basal and postchemotherapy levels within each group and between two groups. Although postchemotherapy D-dimer levels were statistically higher in the FEC group than in the EC group, results in both groups were within normal ranges. More studies concerning the role of fibrinolytic system in breast cancer patients receiving chemotherapy, probably including cases with advanced stage and with different chemotherapy regimens and dose intensities, are needed.
已有报道称，接受乳腺癌全身化疗的女性血栓栓塞事件的发生率有所增加。本研究调查了蒽环类辅助化疗方案对可手术乳腺癌患者纤溶系统标志物纤溶酶原激活物抑制剂-1（PAI-1）和凝血酶激活的纤溶抑制物（TAFI）的影响。24例可手术乳腺癌患者（中位年龄54.5岁；范围37 - 72岁）纳入本研究。Ⅰ - Ⅱ期和ⅢA期病例分别接受EC（表柔比星90 mg/m²/d1，静脉注射；环磷酰胺600 mg/m²/d1，静脉注射）和FEC（5-氟尿嘧啶500 mg/m²/d1，静脉注射；表柔比星100 mg/m²/d1，静脉注射；环磷酰胺500 mg/m²/d1，静脉注射）作为辅助化疗方案。每组由12例患者组成。在基线时以及EC化疗方案第三个周期和FEC化疗方案第四个周期前采集血样。每组内化疗前和化疗后血浆TAFI抗原和PAI-1水平在统计学上无差异，两组之间也无差异。虽然化疗后FEC组的D-二聚体水平在统计学上高于EC组，但两组结果均在正常范围内。需要开展更多关于纤溶系统在接受化疗的乳腺癌患者中的作用的研究，可能包括晚期病例以及采用不同化疗方案和剂量强度的病例。
