癌症患者的血栓预防作用：新出现的数据。
The role of thromboprophylaxis in cancer patients: emerging data.
机构信息
James P. Wilmot Cancer Center, Department of Medicine, University of Rochester, Rochester, New York 14642, USA.
出版信息
Curr Opin Hematol. 2010 Sep;17(5):450-6. doi: 10.1097/MOH.0b013e32833c0760.
PURPOSE OF REVIEW
Venous thromboembolism (VTE) is a frequent cause of morbidity and mortality in cancer patients. A significant proportion of cancer-associated VTE occurs in the ambulatory setting and is associated with poorer outcomes and reduced survival. Risk for VTE is influenced by patient, cancer and treatment-specific factors.
RECENT FINDINGS
Recent studies have identified biomarkers associated with increased VTE risk in malignancy, including leukocyte and platelet counts, tissue factor, prothrombin split products, D-dimer, P-selectin, factor VIII and C-reactive protein. Recent and ongoing clinical trials have focused on VTE prophylaxis with low-molecular weight heparins in high-risk cancer outpatients, particularly those with pancreatic cancer. These studies have yielded encouraging preliminary results but whether thromboprophylaxis provides significant benefit to unselected cancer outpatients remains unclear.
SUMMARY
A risk stratification model incorporating known risk factors and biomarkers can identify those patients at highest risk. This review focuses on emerging data regarding risk assessment and benefit of thromboprophylaxis in patients with cancer.
目的综述
静脉血栓栓塞症（VTE）是癌症患者发病率和死亡率的一个重要原因。相当一部分与癌症相关的 VTE 发生在门诊环境中，与较差的结局和降低的生存率相关。VTE 的风险受到患者、癌症和治疗特异性因素的影响。
最新发现
最近的研究已经确定了与恶性肿瘤中 VTE 风险增加相关的生物标志物，包括白细胞和血小板计数、组织因子、凝血酶原片段、D-二聚体、P-选择素、因子 VIII 和 C 反应蛋白。最近和正在进行的临床试验集中在使用低分子量肝素对高风险的门诊癌症患者进行 VTE 预防，特别是那些患有胰腺癌的患者。这些研究取得了令人鼓舞的初步结果，但血栓预防是否能给未选择的门诊癌症患者带来显著益处尚不清楚。
总结
一个包含已知风险因素和生物标志物的风险分层模型可以识别出那些风险最高的患者。这篇综述重点介绍了关于癌症患者风险评估和血栓预防获益的最新数据。
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