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癌症相关性血栓形成的发病机制。

The pathogenesis of cancer-associated thrombosis.

机构信息

Advanced Medical Science of Thrombosis and Hemostasis, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan.

出版信息

Int J Hematol. 2024 May;119(5):495-504. doi: 10.1007/s12185-024-03735-x. Epub 2024 Feb 29.

Abstract

Patients with cancer have a higher risk of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), compared to the general population. Cancer-associated thrombosis (CAT) is a thrombotic event that occurs as a complication of cancer or cancer therapy. Major factors determining VTE risk in cancer patients include not only treatment history and patient characteristics, but also cancer type and site. Cancer types can be broadly divided into three groups based on VTE risk: high risk (pancreatic, ovarian, brain, stomach, gynecologic, and hematologic), intermediate risk (colon and lung), and low risk (breast and prostate). This implies that the mechanism of VTE differs between cancer types and that specific VTE pathways may exist for different cancer types. This review summarizes the specific pathways that contribute to VTE in cancer patients, with a particular focus on leukocytosis, neutrophil extracellular traps (NETs), tissue factor (TF), thrombocytosis, podoplanin (PDPN), plasminogen activator inhibitor-1 (PAI-1), the intrinsic coagulation pathway, and von Willebrand factor (VWF).

摘要

与普通人群相比,癌症患者(包括深静脉血栓形成[DVT]和肺栓塞[PE])发生静脉血栓栓塞(VTE)的风险更高。癌症相关性血栓形成(CAT)是一种作为癌症或癌症治疗并发症而发生的血栓事件。决定癌症患者 VTE 风险的主要因素不仅包括治疗史和患者特征,还包括癌症类型和部位。基于 VTE 风险,癌症类型可大致分为三组:高风险(胰腺、卵巢、脑、胃、妇科和血液学)、中风险(结肠和肺)和低风险(乳腺和前列腺)。这意味着不同癌症类型的 VTE 机制不同,不同癌症类型可能存在特定的 VTE 途径。本综述总结了导致癌症患者 VTE 的具体途径,特别关注白细胞增多、中性粒细胞胞外诱捕网(NETs)、组织因子(TF)、血小板增多、足细胞 podoplanin(PDPN)、纤溶酶原激活物抑制剂-1(PAI-1)、内在凝血途径和血管性血友病因子(VWF)。

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