Yamashita Yoshiki, Wada Hideo, Nomura Hideki, Mizuno Toshiro, Saito Kanako, Yamada Norikazu, Asanuma Kunihiro, Usui Masanobu, Kamimoto Yuki, Matsumoto Takeshi, Ohishi Kohshi, Katayama Naoyuki
Departments of Hematology and Oncology, Mie University Graduate School of Medicine, Japan.
Intern Med. 2014;53(5):413-9. doi: 10.2169/internalmedicine.53.1102.
Many patients with malignant diseases are frequently complicated with some type of thrombosis, such as venous thromboembolism (VTE) or disseminated intravascular coagulation (DIC).
This retrospective study was designed to examine the frequency of thrombosis in 478 patients with malignant diseases in comparison to that observed in 121 patients without malignant diseases and to evaluate the efficacy of fibrin-related markers (FRMs), such as soluble fibrin, fibrinogen and fibrin degradation products and D-dimer, in diagnosing thrombosis.
The frequency of thrombosis, including 62 cases of VTE, 63 cases of DIC and nine cases of cerebrovascular thrombosis, was significantly higher in the patients with malignant diseases (28.0%) than in the patients without malignant diseases (12.5%). DIC was frequently detected in the patients with hepatic cell cancer and hematopoietic malignancy, while VTE was frequently observed in the patients with colon cancer, breast cancer and urinary tract cancer. The FRMs levels were significantly higher in the patients with thrombosis than in the patients without thrombosis. A receiver operating characteristic analysis showed these markers to be useful for diagnosing thrombosis.
Patients with malignant diseases have a high risk of thrombosis, and elevated FRMs levels are useful for diagnosing thrombosis in patients with malignant diseases.
许多恶性疾病患者常并发某种类型的血栓形成,如静脉血栓栓塞症(VTE)或弥散性血管内凝血(DIC)。
本回顾性研究旨在比较478例恶性疾病患者与121例非恶性疾病患者的血栓形成发生率,并评估纤维蛋白相关标志物(FRMs),如可溶性纤维蛋白、纤维蛋白原、纤维蛋白降解产物和D-二聚体在诊断血栓形成中的有效性。
恶性疾病患者的血栓形成发生率(28.0%)显著高于非恶性疾病患者(12.5%),其中包括62例VTE、63例DIC和9例脑血管血栓形成。肝细胞癌和血液系统恶性肿瘤患者常检测到DIC,而结肠癌、乳腺癌和泌尿系统癌症患者常观察到VTE。血栓形成患者的FRMs水平显著高于无血栓形成患者。受试者工作特征分析表明这些标志物对诊断血栓形成有用。
恶性疾病患者有较高的血栓形成风险,FRMs水平升高有助于诊断恶性疾病患者的血栓形成。