Hügli A, Beris P
Département de Médecine, Hôpital Cantonal Universitaire de Genève, Suisse.
Nouv Rev Fr Hematol (1978). 1989;31(3):223-30.
Between 1981 and 1988, we recorded 11 patients presenting a neoplastic microangiopathy. All patients suffered from adenocarcinoma, except one with an undifferentiated lung carcinoma; the origin of the tumor was mammary in 5 cases and gastric in 3. In our study, microangiopathy was the first manifestation of the neoplastic disease on 3 occasions; on 7 occasions it was a complication of an advanced stage of a known oncological disease; and on 1 occasion it occurred during a course of intra-arterial chemotherapy. Regenerative anemia (mean 9.5 g/dl hemoglobin), thrombocytopenia (mean 42,000 platelets/mm3), and an elevated LDH value (mean 1,268 U/l) characterized these patients. Disseminated intravascular coagulopathy (DIC) was found in half the cases in which it was sought. In spite of aggressive antitumoral treatment, the course was disastrous with an average survival of 13.6 days. The most frequent causes of death were renal insufficiency or hemorrhagic diathesis. These data corroborate those cited in the literature since 1979, and are consistent with those reported by Antman during the period 1962-1979.
1981年至1988年间,我们记录了11例呈现肿瘤性微血管病的患者。除1例为未分化肺癌外,所有患者均患有腺癌;肿瘤起源于乳腺的有5例,起源于胃的有3例。在我们的研究中,微血管病有3次是肿瘤性疾病的首发表现;有7次是已知肿瘤疾病晚期的并发症;有1次发生在动脉内化疗过程中。这些患者的特征为再生性贫血(血红蛋白平均9.5g/dl)、血小板减少(血小板平均42,000/mm³)以及乳酸脱氢酶值升高(平均1,268U/l)。在半数进行检查的病例中发现了弥散性血管内凝血(DIC)。尽管进行了积极的抗肿瘤治疗,但病情仍很严重,平均生存期为13.6天。最常见的死亡原因是肾功能不全或出血素质。这些数据证实了自1979年以来文献中引用的数据,并且与1962年至1979年期间Antman报告的数据一致。