Wrzeszcz Katarzyna, Rhone Piotr, Kwiatkowska Katarzyna, Ruszkowska-Ciastek Barbara
Department of Pathophysiology, Faculty of Pharmacy, Nicolaus Copernicus University, Collegium Medicum, 85-094 Bydgoszcz, Poland.
Clinical Ward of Breast Cancer and Reconstructive Surgery, Oncology Centre Prof. F. Łukaszczyk Memorial Hospital, 85-796 Bydgoszcz, Poland.
Life (Basel). 2023 Apr 28;13(5):1106. doi: 10.3390/life13051106.
(1) Background: Cancer treatment, including chemotherapy, endocrine therapy, targeted therapy and radiotherapy, has been identified as an important independent risk factor for venous thromboembolism in cancer patients. The aim of the study was to evaluate the effect of adjuvant therapy on the coagulation and fibrinolysis components in invasive breast cancer. (2) Methods: Tissue factor pathway inhibitor (TFPI), tissue factor (TF), tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) antigen (concentration) and TFPI and TF activities were examined in the blood samples of 60 breast cancer patients treated by adjuvant chemotherapy, endocrine therapy, radiotherapy and immunotherapy. Blood samples were taken 24 h before primary surgery and 8 months after tumour removal surgery. (3) Results: Adjuvant therapy administrated to breast cancer patients significantly increased the concentration of plasma TF, the PAI-1 antigen and also the activity of TFPI and TF, but significantly decreased the level of the t-PA antigen. Combined chemotherapy and endocrine therapy, but not monotherapy, has an important effect on haemostatic biomarker levels. (4) Conclusions: Breast cancer patients receiving adjuvant therapy have an elevated risk of developing a hypercoagulability and hypofibrinolysis state leading to venous thromboembolism.
（1）背景：癌症治疗，包括化疗、内分泌治疗、靶向治疗和放疗，已被确定为癌症患者静脉血栓栓塞的重要独立危险因素。本研究的目的是评估辅助治疗对浸润性乳腺癌患者凝血和纤溶成分的影响。（2）方法：检测了60例接受辅助化疗、内分泌治疗、放疗和免疫治疗的乳腺癌患者血液样本中的组织因子途径抑制物（TFPI）、组织因子（TF）、组织型纤溶酶原激活物（t-PA）、纤溶酶原激活物抑制剂-1（PAI-1）抗原（浓度）以及TFPI和TF活性。在初次手术前24小时和肿瘤切除手术后8个月采集血样。（3）结果：对乳腺癌患者进行辅助治疗显著提高了血浆TF浓度、PAI-1抗原水平以及TFPI和TF的活性，但显著降低了t-PA抗原水平。联合化疗和内分泌治疗而非单一治疗，对止血生物标志物水平有重要影响。（4）结论：接受辅助治疗的乳腺癌患者发生导致静脉血栓栓塞的高凝和低纤溶状态的风险升高。
