Seki Yoshinobu
Department of Hematology, Niigata University Medical and Dental Hospital.
Department of Hematology, Niigata Cancer Center Hospital.
Rinsho Ketsueki. 2025;66(8):833-841. doi: 10.11406/rinketsu.66.833.
Disseminated intravascular coagulation (DIC) is a cancer-associated paraneoplastic syndrome. Solid cancers typically present with a clinical form of chronic DIC in which thrombocytopenia due to hypercoagulable activation is balanced with platelet production in the bone marrow over an extended period. Certain disseminated cancers also present with rapid-onset, severe DIC. Additionally, as a cancer-associated thrombosis (CAT), DIC is characterized by a hypercoagulable state, frequently leading to pathological thromboses such as deep vein thrombosis, pulmonary embolism, or cerebral infarction. If DIC is not diagnosed and treated promptly and appropriately, it can significantly worsen prognosis and quality of life in cancer patients. Therefore, it is essential to consider DIC during the routine clinical management of solid cancers. This review discusses the pathogenesis of DIC associated with solid cancers, as well as diagnostic methods and treatment methods and principles based on the recently published Clinical Practice Guidelines for management of DIC in Japan 2024 by the Japanese Society on Thrombosis and Hemostasis.
弥散性血管内凝血（DIC）是一种与癌症相关的副肿瘤综合征。实体癌通常表现为慢性DIC的临床形式，其中由于高凝激活导致的血小板减少在较长时间内与骨髓中的血小板生成保持平衡。某些播散性癌症也表现为快速发作的严重DIC。此外，作为一种与癌症相关的血栓形成（CAT），DIC的特征是高凝状态，经常导致病理性血栓形成，如深静脉血栓形成、肺栓塞或脑梗死。如果DIC未得到及时和适当的诊断与治疗，它会显著恶化癌症患者的预后和生活质量。因此，在实体癌的常规临床管理中考虑DIC至关重要。本综述根据日本血栓与止血学会最近发布的《2024年日本DIC管理临床实践指南》，讨论了与实体癌相关的DIC的发病机制以及诊断方法、治疗方法和原则。
