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作为隐匿性癌症临床主要症状的静脉血栓栓塞的早期诊断:静脉血栓的核心蛋白

Early diagnosis of venous thromboembolism as a clinical primary symptom of occult cancer: Core proteins of a venous thrombus.

作者信息

Wen Siwan, Duan Qianglin, Yang Fan, Li Guiyuan, Wang Lemin

机构信息

Department of Cardiology, Tongji University Affiliated to Tongji Hospital, Shanghai 200065, P.R. China.

Department of Clinical Laboratory, Tongji University Affiliated to Tongji Hospital, Shanghai 200065, P.R. China.

出版信息

Oncol Lett. 2017 Jul;14(1):491-496. doi: 10.3892/ol.2017.6175. Epub 2017 May 16.

Abstract

Malignancy is one of the risk factors of venous thromboembolism (VTE). As a common accompanying factor of malignant tumors, almost 20% of idiopathic VTEs are identified in patients with occult types of cancer as the primary symptom. The type of internal association that exists between malignant tumors and VTE has not yet been determined. The present review discusses the following: i) Reversible combinations between core proteins of venous thrombi and their ligand proteins. With the condition of immune cell balancing function collapse, which is characterized as dysfunction immune cells and impaired immune functions, the human body loses the function of eliminating infectious/malignant cells quickly and effectively. Thus, integrins β2 and β3 on the membrane of platelets and white blood cells are activated to combine with fibrinogen ligands to form an intravenous mesh-like structure, which acts as an intravenous biological filter that prevents infectious/malignant cells from flowing back into the circulatory system. During the defense process, blood cells (mainly red blood cells) stagnate and fill the filter, which results in venous thrombotic diseases. ii) Tumor cells, which cannot be eliminated quickly, proliferate and invade; or ischemic necrosis destroys peripheral tissues and vessels (veins and arteries), resulting in the formation of a biological filter in injured veins. The filter is filled with stranded tumor cells, which prevents the hemorrhagic metastasis of malignant cells. The formation of an intravenous biological filter results from the transition of the body's own defense capabilities, which is also a physical/histopathological phenomenon. iii) An increase in the number of core proteins in a venous thrombus is a basic molecular step in the formation of intravenous biological filters, which is also defined as a marker of the newly initiated defensive barrier. Increased levels of integrins β1, β2 and β3 are useful in not only the specific diagnosis of VTE, but also in the early recognition of occult malignant tumors in idiopathic VTE patients.

摘要

恶性肿瘤是静脉血栓栓塞症(VTE)的危险因素之一。作为恶性肿瘤的常见伴随因素,近20%的特发性VTE患者以隐匿性癌症为主要症状被确诊。恶性肿瘤与VTE之间存在的内在关联类型尚未确定。本综述讨论以下内容:i)静脉血栓核心蛋白与其配体蛋白之间的可逆结合。在以免疫细胞功能失调和免疫功能受损为特征的免疫细胞平衡功能崩溃的情况下,人体失去快速有效清除感染性/恶性细胞的功能。因此,血小板和白细胞膜上的整合素β2和β3被激活,与纤维蛋白原配体结合,形成静脉网状结构,作为静脉生物过滤器,防止感染性/恶性细胞回流到循环系统中。在防御过程中,血细胞(主要是红细胞)停滞并填充过滤器,导致静脉血栓性疾病。ii)无法迅速清除的肿瘤细胞增殖并侵袭;或缺血性坏死破坏周围组织和血管(静脉和动脉),导致受损静脉中形成生物过滤器。过滤器中充满滞留的肿瘤细胞,可防止恶性细胞发生出血性转移。静脉生物过滤器的形成源于机体自身防御能力的转变,这也是一种物理/组织病理学现象。iii)静脉血栓中核心蛋白数量的增加是静脉生物过滤器形成的基本分子步骤,这也被定义为新启动的防御屏障的标志物。整合素β1、β2和β3水平的升高不仅有助于VTE的特异性诊断,还有助于特发性VTE患者隐匿性恶性肿瘤的早期识别。

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