Horowitz Netanel, Brenner Benjamin
Thrombosis and Hemostasis Unit, Department of Hematology, Rambam Health Care Campus, Haifa, Israel.
Pathophysiol Haemost Thromb. 2008;36(3-4):131-6. doi: 10.1159/000175151. Epub 2009 Jan 27.
Inherited and acquired thrombophilia are well-known risk factors for venous thromboembolism. The incidence of thrombotic events in cancer patients is increased compared to normal population. Data on inherited thrombophilia and cancer is limited. Most studies are small, and results are varied by geography, tumor type, stage of disease and therapy. Nevertheless, it seems that factor V Leiden and prothrombin mutation may increase VTE risk in cancer patients. Data also exist for hyperhomocysteinemia. Cancer patients with thrombophilia who have a central vein catheter are a special group with increased venous thrombotic event (VTE) risk. Among acquired risk factors, antiphospholipid antibodies are common in cancer patients, especially in lymphoproliferative diseases. Published data suggests that the risk of thrombotic events, venous and arterial, is increased in cancer patients with antiphospholipid antibodies. The questions of screening cancer patients for inherited thrombophilia or antiphospholipid antibodies are unclear. There is no data on primary VTE prophylaxis in cancer patients with thrombophilia and prophylaxis for cancer patients with central vein catheters is controversial.
遗传性和获得性血栓形成倾向是静脉血栓栓塞的众所周知的危险因素。与正常人群相比,癌症患者发生血栓事件的发生率更高。关于遗传性血栓形成倾向与癌症的数据有限。大多数研究规模较小,结果因地理位置、肿瘤类型、疾病阶段和治疗方法而异。然而,似乎因子V莱顿突变和凝血酶原突变可能会增加癌症患者发生静脉血栓栓塞的风险。关于高同型半胱氨酸血症的数据也有存在。患有血栓形成倾向且留置中心静脉导管的癌症患者是静脉血栓事件(VTE)风险增加的特殊群体。在获得性危险因素中,抗磷脂抗体在癌症患者中很常见,尤其是在淋巴增殖性疾病中。已发表的数据表明,患有抗磷脂抗体的癌症患者发生静脉和动脉血栓事件的风险会增加。对于癌症患者进行遗传性血栓形成倾向或抗磷脂抗体筛查的问题尚不清楚。对于患有血栓形成倾向的癌症患者进行原发性VTE预防以及对留置中心静脉导管的癌症患者进行预防存在争议。