CMID, Centro Multidisciplinare di Ricerche di Immunopatologia e Documentazione su Malattie Rare, Struttura Complessa a Direzione Universitaria di Immunologia Clinica, Giovanni Bosco Hospital, Turin, Italy.
Intern Emerg Med. 2009 Dec;4(6):491-5. doi: 10.1007/s11739-009-0316-6. Epub 2009 Sep 26.
Antiphospholipid antibodies (aPL) represent a well-defined risk factor for thrombotic events. aPL have been observed in the plasma of cancer patients, but the role and clinical relevance of aPL in this clinical setting is still unclear. This is a prospective cohort study whose aims were to: (1) compare the prevalence of aPL antibodies in cancer patients at diagnosis to matched control subjects; (2) compare thrombosis-free survival and overall survival in aPL positive and aPL negative cancer patients. One hundred and thirty-seven patients were enrolled upon a diagnosis of cancer, and were screened for lupus anticoagulant (LA), anticardiolipin antibodies, and anti-beta2 glycoprotein I antibodies (IgG and IgM). Two years of follow-up were scheduled. Low-titre aPL antibody positivity was found in 33 patients (24%), and in 6 controls (4.3%; P < 0.0001). During follow-up, nine patients developed a symptomatic, objectively confirmed, thromboembolic event. One thrombotic event was observed among the 33 aPL positive patients (3%), and 8 among the 104 aPL negative ones (7.6%) (P = NS). During follow-up, 21 patients died, and among them, 3 (9.1%) were aPL positive and 18 (17.3%) were aPL negative (P = 0.39; C.I. 0.28-0.05). In conclusion, a high prevalence of low-titre aPL was found in cancer patients at diagnosis, but no statistical difference in thrombosis-free survival or in overall survival was observed between aPL positive and aPL negative patients.
抗磷脂抗体（aPL）是血栓形成事件的明确危险因素。已经在癌症患者的血浆中观察到 aPL，但 aPL 在这种临床环境中的作用和临床相关性尚不清楚。这是一项前瞻性队列研究，旨在：（1）比较癌症患者诊断时 aPL 抗体的患病率与匹配的对照组；（2）比较 aPL 阳性和 aPL 阴性癌症患者的无血栓生存和总生存。在诊断出癌症后，共招募了 137 名患者，并对狼疮抗凝剂（LA）、抗心磷脂抗体和抗β2 糖蛋白 I 抗体（IgG 和 IgM）进行了筛查。安排了 2 年的随访。发现低滴度 aPL 抗体阳性的患者有 33 例（24%），对照组有 6 例（4.3%；P < 0.0001）。在随访期间，9 名患者发生了有症状的、客观证实的血栓栓塞事件。在 33 名 aPL 阳性患者中有 1 例（3%）发生血栓事件，而在 104 名 aPL 阴性患者中有 8 例（7.6%）（P = NS）。在随访期间，21 名患者死亡，其中 3 名（9.1%）为 aPL 阳性，18 名（17.3%）为 aPL 阴性（P = 0.39；C.I. 0.28-0.05）。总之，在癌症患者诊断时发现了高比例的低滴度 aPL，但 aPL 阳性和 aPL 阴性患者之间的无血栓生存或总生存没有统计学差异。
