Department of Cardiologic, Thoracic and Vascular Sciences, via Giustiniani 2, Padua, Italy.
Thromb Haemost. 2013 Aug;110(2):378-85. doi: 10.1160/TH12-12-0957. Epub 2013 Jun 27.
Venous thromboembolism (VTE) may complicate the clinical course of glioblastoma multiforme (GBM). Circulating microparticles (MPs) have been associated with cancer-related VTE. Sixty-one consecutive patients with GBM undergoing gross-total (41) or subtotal (20) surgical resection followed by radio-chemotherapy were prospectively evaluated. MPs numbers according to cellular origin and the procoagulant activity of annexin V positive (AV+) MPs (MP-activity) were measured before surgery and then 1 week and 1, 4, and 7 months after surgery. Glial (GFAP+) and endothelial (CD62E+) derived MPs, AV+ and tissue factor-bearing (TF+) MPs were measured using flow cytometry. Baseline levels of GFAP+/TF-, TF+/GFAP-, and GFAP+/TF+ MPs were significantly higher in GBM patients than in healthy controls, and significantly increased at each time point after surgery; at 7 months, a further significant increase over the level found a week after surgery was only seen in the subtotally resected patients. The number AV+/CD62E- MPs increased in GBM patients and correlated with MP activity. TF+/GFAP- MPs numbers were significantly higher in 11 GBM patients who developed VTE than in those who did not (p 0.04). TF+/GFAP- MPs levels above the 90th percentile (calculated in GBM patients without VTE) were associated with a higher risk of VTE (RR 4.17, 95% CI 1.57-11.03). In conclusion, the numbers of glial-derived and/or TF-bearing MPs were high in GBM patients both before and even more after the neoplasm was treated, especially in patients with subtotal resection likely according to disease progression. A contribution of TF+/GFAP- MPs to the risk of VTE is suggested.
静脉血栓栓塞症（VTE）可能会使多形性胶质母细胞瘤（GBM）的临床病程复杂化。循环微颗粒（MPs）与癌症相关的 VTE 有关。61 例连续接受大体全切除（41 例）或次全切除（20 例）手术，随后接受放化疗的 GBM 患者前瞻性评估。在手术前、手术后 1 周、1 个月、4 个月和 7 个月时，根据细胞起源测量 MPs 数量，并测量 Annexin V 阳性（AV + ）MPs 的促凝活性（MP-活性）。使用流式细胞术测量胶质（GFAP + ）和内皮（CD62E + ）衍生的 MPs、AV + 和组织因子（TF + ）携带的 MPs。与健康对照组相比，GBM 患者的基线 GFAP + /TF-、TF + /GFAP-和 GFAP + /TF + MPs 水平显著升高，并且在手术后的每个时间点均显著增加；在 7 个月时，仅在次全切除患者中发现手术后 1 周的水平进一步增加。GBM 患者的 AV + /CD62E- MPs 数量增加，并与 MP 活性相关。在 11 例发生 VTE 的 GBM 患者中，TF + /GFAP- MPs 数量明显高于未发生 VTE 的患者（p 0.04）。TF + /GFAP- MPs 水平高于 90 百分位数（在无 VTE 的 GBM 患者中计算）与 VTE 风险增加相关（RR 4.17，95%CI 1.57-11.03）。总之，在 GBM 患者中，胶质衍生和/或 TF 携带的 MPs 数量在肿瘤治疗前后均较高，尤其是在疾病进展的次全切除患者中。TF + /GFAP- MPs 可能对 VTE 的风险有一定的影响。
