Department of Cardiologic, Thoracic, and Vascular Sciences, 2nd Chair of Internal Medicine, University of Padua Medical School, Padua, Italy.
Thromb Res. 2011 May;127(5):473-7. doi: 10.1016/j.thromres.2011.01.002. Epub 2011 Jan 22.
Cancer is a prothrombotic state, with an increased prevalence of venous thromboembolism (VTE). Microparticles (MPs) are sub-micron-sized vesicles derived from activated or apoptotic cells that may play a role in VTE, although evidence of this association is still limited.
To evaluate the hypothesis that elevated numbers of endothelial (EMPs), platelets (PMPs), and Tissue Factor-bearing MPs (TF(+)MPs) in plasma may contribute to cancer-associated thrombosis.
PATIENTS/METHODS: EMPs, PMPs and TF(+)MPs plasma levels were measured in 90 consecutive patients (cases) referred to our Department (30 with a first episode of unprovoked VTE; 30 with active cancer; 30 with a diagnosis of acute VTE associated with active cancer), and in a group of 90 healthy subjects (controls). MPs analyses were performed by flow-cytometry (Cytomics FC500).
Cases showed statistically significant higher (mean ± SD) circulating EMPs and PMPs plasma levels (920 ± 341 and 1221 ± 413 MP/μL, respectively) than controls (299 ± 102 and 495 ± 241 MP/μL; p<0.005). Moreover cancer patients (with and without VTE) showed higher (mean ± SD) TF(+)MPs (927 ± 415 MPs/μL) than controls (204 ± 112 MPs/μL; p<0.001). The subgroup of cancer patients plus VTE showed statistically significant higher TF(+)MPs plasma levels (1019 ± 656 MPs/μL) than cancer patients without VTE (755 ± 391 MPs/μL, p = 0.002). Multivariate analysis failed to show a significant association between elevated TF(+)MPs and VTE in cancer patients.
Our results suggest that MPs might be an important intermediate in the cascade of cellular injury and vascular dysfunctions underlying the process of thrombosis, particularly in cancer. Further clinical investigations are needed to confirm the precise role of MPs in predicting hypercoagulable state in patients with cancer.
癌症是一种促血栓形成状态，静脉血栓栓塞症（VTE）的患病率增加。微粒（MPs）是源自激活或凋亡细胞的亚微米大小的囊泡，可能在 VTE 中起作用，尽管这一关联的证据仍然有限。
评估假设，即血浆中升高的内皮（EMP）、血小板（PMP）和组织因子携带的 MPs（TF(+)MPs）数量可能导致癌症相关的血栓形成。
患者/方法：测量了 90 名连续患者（病例）（30 名首次发生无诱因 VTE；30 名患有活动性癌症；30 名诊断为伴有活动性癌症的急性 VTE）和 90 名健康受试者（对照组）的 EMPs、PMPs 和 TF(+)MPs 血浆水平。 MPs 分析通过流式细胞术（Cytomics FC500）进行。
病例组显示循环 EMPs 和 PMPs 血浆水平显著升高（平均值±标准差分别为 920±341 和 1221±413 MPs/μL），明显高于对照组（299±102 和 495±241 MPs/μL；p<0.005）。此外，癌症患者（有或没有 VTE）的 TF(+)MPs（927±415 MPs/μL）也高于对照组（204±112 MPs/μL；p<0.001）。癌症加 VTE 的亚组 TF(+)MPs 血浆水平明显升高（1019±656 MPs/μL），明显高于无 VTE 的癌症患者（755±391 MPs/μL，p=0.002）。多变量分析未能显示 TF(+)MPs 升高与癌症患者 VTE 之间存在显著关联。
我们的结果表明，MPs 可能是细胞损伤和血管功能障碍级联反应的重要中间产物，这是血栓形成过程中的关键步骤，尤其是在癌症中。需要进一步的临床研究来证实 MPs 在预测癌症患者高凝状态中的精确作用。
