癌症患者的促凝血因子。

Procoagulant factors in patients with cancer.

作者信息

Molnar Soledad, Guglielmone Hugo, Lavarda Marcelo, Rizzi Maria Laura, Jarchum Gustavo

机构信息

Division of Hematology and Oncology, Cordoba, Argentina.

出版信息

Hematology. 2007 Dec;12(6):555-9. doi: 10.1080/10245330701521416.

DOI:10.1080/10245330701521416

PMID:17852460

Abstract

BACKGROUND

Clotting activation and thromboembolic manifestations are common features in patients with cancer. Tumor cells can directly activate the clotting through two procoagulants: tissue factor (TF) and cancer procoagulant (CP).

AIMS

The aim was to evaluate the levels of TF and CP in patients with different tumors in order to: (1) establish an association between these markers and the tumor localization, (2) establish a correlation between the levels of procoagulants and the status of the disease, (3) evaluate if the treatment with chemotherapy induced some modifications on the levels of procoagulants, (4) evaluate the possibility of using procoagulants as predictors in the development of thrombosis.

METHODS

Sixty-one patients with different types of cancer (lung, breast, digestive and genitourinary) and 20 normal controls were included. The activity of TF and CP was studied in serum samples. Statistical analysis of the data was performed by two-tailed Fisher exact test.

RESULTS

The TF was increased in 72.5 and 0% (p < 0.01) of cancer patients and normal controls, respectively. PC was found to be increased in 88% of the cancer patients but in healthy controls it was increased in only 15% (p < 0.01). The patients with genitourinary cancer presented the highest values of both procoagulants coinciding with a major prevalence of thrombotic events. The activity CP was found in 93% of patients with stages I and II but in patients with stages II and IV disease it was found in 85% (not significant). There were no differences in the levels of both procoagulants between the patients treated with chemotherapy and those with other treatments.

CONCLUSIONS

TF and CP are elevated in patients with cancer. The highest values of both procoagulants are in the genitourinary cancer group in agreement with the greater presence of thrombosis observed in this group. Clinical follow up is important in order to determine the potential value of these procoagulants and the tendency to develop thrombosis in patients with cancer.

摘要

背景

凝血激活和血栓栓塞表现是癌症患者的常见特征。肿瘤细胞可通过两种促凝剂直接激活凝血：组织因子（TF）和癌促凝剂（CP）。

目的

旨在评估不同肿瘤患者的TF和CP水平，以便：（1）确定这些标志物与肿瘤定位之间的关联；（2）确定促凝剂水平与疾病状态之间的相关性；（3）评估化疗治疗是否会引起促凝剂水平的某些变化；（4）评估使用促凝剂作为血栓形成预测指标的可能性。

方法

纳入61例不同类型癌症（肺癌、乳腺癌、消化系统癌和泌尿生殖系统癌）患者及20名正常对照。在血清样本中研究TF和CP的活性。采用双侧Fisher精确检验对数据进行统计分析。

结果

癌症患者和正常对照中TF升高的比例分别为72.5%和0%（p<0.01）。发现88%的癌症患者CP升高，而健康对照中仅15%升高（p<0.01）。泌尿生殖系统癌症患者的两种促凝剂值最高，同时血栓形成事件的发生率也最高。在Ⅰ期和Ⅱ期患者中93%检测到CP活性，而在Ⅱ期和Ⅳ期疾病患者中为85%（无显著性差异）。接受化疗的患者与接受其他治疗的患者之间，两种促凝剂水平无差异。