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非自愿体重减轻患者中抗磷脂抗体与癌症的标准及非标准情况

Criteria and Non-Criteria Antiphospholipid Antibodies and Cancer in Patients with Involuntary Weight Loss.

作者信息

Caraiola Simona, Voicu Laura, Baicus Anda, Baicus Cristian

机构信息

Fifth Department-Internal Medicine (Cardiology, Gastroenterology, Hepatology, Rheumatology, Geriatrics), Family Medicine, Occupational Medicine, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Internal Medicine Department, Colentina Clinical Hospital, 020125 Bucharest, Romania.

出版信息

J Pers Med. 2023 Oct 29;13(11):1549. doi: 10.3390/jpm13111549.

Abstract

Cancer patients have higher prevalences of antiphospholipid antibodies (aPLs), occasionally associated with thrombotic events. A cross-sectional study regarding the presence of criteria (IgG/IgM anti-cardiolipin-aCL, anti-β2 glycoprotein I-aβ2GPI) and non-criteria (IgG/IgM anti-phosphatidylserine-aPS, anti-phosphatidylethanolamine-aPE, anti-prothrombin-aPT) aPLs in 146 patients with involuntary weight loss was performed. None of the patients had thrombotic events during the study. Out of the 36 cancer patients, 33 had non-hematologic malignancies. In the cancer subgroup, 60% of the patients had at least one positive aPL, with significantly more patients being positive for aβ2GPI IgG compared with the non-cancer subgroup- = 0.03, OR = 2.23 (1.02-4.88). When evaluating the titres, aCL IgG/IgM, aβ2GPI IgG, aPE IgG, and aPS IgG had significantly higher values in cancer patients, the best cancer predictor being aβ2GPI IgG-AUC 0.642 (0.542-0.742). Gastrointestinal cancer patients were studied separately, and aCL IgM positivity was significantly higher- = 0.008, OR = 6.69 (1.35-33.02). Both the titres of aCL IgM ( = 0.006) and aPS IgM ( = 0.03) were higher in the gastrointestinal cancer subgroup, with aCL IgM being the best predictor for gastrointestinal cancer development-AUC 0.808 (0.685-0.932). Despite criteria and non-criteria aPLs being frequent in cancer, their connection with thrombosis in these patients is probably dependent on other important risk factors and needs further research.

摘要

癌症患者抗磷脂抗体(aPLs)的患病率较高,偶尔与血栓形成事件相关。对146例体重非自愿减轻的患者进行了一项关于标准(IgG/IgM抗心磷脂-aCL、抗β2糖蛋白I-aβ2GPI)和非标准(IgG/IgM抗磷脂酰丝氨酸-aPS、抗磷脂酰乙醇胺-aPE、抗凝血酶原-aPT)aPLs存在情况的横断面研究。在研究期间,没有患者发生血栓形成事件。在36例癌症患者中,33例患有非血液系统恶性肿瘤。在癌症亚组中,60%的患者至少有一种aPL呈阳性,与非癌症亚组相比,aβ2GPI IgG呈阳性的患者明显更多(P = 0.03,OR = 2.23[1.02 - 4.88])。在评估滴度时,癌症患者的aCL IgG/IgM、aβ2GPI IgG、aPE IgG和aPS IgG的值明显更高,最佳的癌症预测指标是aβ2GPI IgG-AUC为0.642(0.542 - 0.742)。对胃肠道癌症患者进行了单独研究,aCL IgM阳性率明显更高(P = 0.008,OR = 6.69[1.35 - 33.02])。胃肠道癌症亚组中aCL IgM(P = 0.006)和aPS IgM(P = 0.03)的滴度均更高,aCL IgM是胃肠道癌症发生的最佳预测指标-AUC为0.808(0.685 - 0.932)。尽管标准和非标准aPLs在癌症中很常见,但它们与这些患者血栓形成的关联可能取决于其他重要的危险因素,需要进一步研究。

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