Lu Guanyu, Jia Lin, Yang Ruohan, Lv Zheng, Cui Jiuwei
Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.
Oncol Lett. 2023 Feb 2;25(3):106. doi: 10.3892/ol.2023.13692. eCollection 2023 Mar.
Fibrinolysis is a bleeding disorder characterized by hypofibrinogenemia caused by abnormal activation of fibrinolytic system function. Patients with cancer are prone to hypercoagulable and should be vigilant for the risk of venous thrombosis. However, patients with tumors in which bleeding is the first manifestation are relatively rare. The present study reports the case of a 52-year-old woman with metastatic breast cancer with acquired hyperfibrinolysis as the first manifestation. Hyperfibrinolysis is an important sign and manifestation of disease progression. In this case, fibrinogen was used as a sensitive biomarker of tumor burden to specifically predict the efficacy of the antitumor therapy. Effective antitumor therapy can improve the hyperfibrinolysis of patients, and so the fibrinogen levels gradually increased. In conclusion, the present case showed acquired hyperfibrinolysis with bleeding symptoms, which is an uncommon paraneoplastic phenomenon in breast cancer, especially when combined with bone marrow metastasis, as in the present case. Timely diagnosis and treatment of the primary disease is the fundamental way to improve hyperfibrinolysis. As an effective biomarker, fibrinogen level predicts the changes in a patient's illness and guides the clinical diagnosis and treatment process.
纤维蛋白溶解症是一种出血性疾病，其特征是由于纤维蛋白溶解系统功能异常激活导致纤维蛋白原血症。癌症患者容易发生高凝状态，应警惕静脉血栓形成的风险。然而，以出血为首发表现的肿瘤患者相对少见。本研究报告了一例52岁女性转移性乳腺癌患者，以获得性纤维蛋白溶解亢进为首发表现。纤维蛋白溶解亢进是疾病进展的重要标志和表现。在该病例中，纤维蛋白原被用作肿瘤负荷的敏感生物标志物，以特异性预测抗肿瘤治疗的疗效。有效的抗肿瘤治疗可改善患者的纤维蛋白溶解亢进情况，使纤维蛋白原水平逐渐升高。总之，本病例显示出伴有出血症状的获得性纤维蛋白溶解亢进，这在乳腺癌中是一种罕见的副肿瘤现象，尤其是像本病例那样合并骨髓转移时。及时诊断和治疗原发疾病是改善纤维蛋白溶解亢进的根本途径。作为一种有效的生物标志物，纤维蛋白原水平可预测患者病情变化并指导临床诊断和治疗过程。
