Cafagna D, Ponte E
I Divisione di Medicina Generale, Ospedale di Cattinara, Trieste.
Minerva Med. 1997 Dec;88(12):523-30.
Thromboembolic disease (TE) is an important cause of in-hospital morbidity and mortality. The relationship between cancer and abnormalities of blood coagulation has been recognized for well over a century. Deep venous thrombosis (DVT) of the lower extremities is the most common cause of thromboembolic disease, but pulmonary embolism, upper extremity vein thrombosis, disseminated intravascular coagulation, and other, more unusual, clinical events, may occur. Unexplained TE may serve as a marker for the presence of a hidden tumor. The frequency of pulmonary embolism (PE) among patients with a malignant neoplasm at necropsy is highly increased in the elderly patients. Among subjects with a malignant neoplasm, patients with pancreatic and gastric cancer (mucin-secreting adenocarcinomas), cancer of the large bowel and women with ovarian cancer had the highest frequency of PE. Old age, female sex, gastrointestinal and ovarian cancers must be considered as a significant risk factor for PE. The potentially responsible mechanisms for the thrombotic events, clinical manifestations, diagnostic implications and aspects of treatment of TE in malignant disease are discussed.
血栓栓塞性疾病（TE）是住院患者发病和死亡的重要原因。癌症与凝血异常之间的关系早在一个多世纪前就已被认识到。下肢深静脉血栓形成（DVT）是血栓栓塞性疾病最常见的原因，但也可能发生肺栓塞、上肢静脉血栓形成、弥散性血管内凝血以及其他更罕见的临床事件。不明原因的TE可能是隐匿性肿瘤存在的标志。尸检时恶性肿瘤患者中肺栓塞（PE）的发生率在老年患者中显著增加。在患有恶性肿瘤的人群中，胰腺癌和胃癌（分泌黏液的腺癌）、大肠癌患者以及卵巢癌女性患者发生PE的频率最高。老年、女性、胃肠道癌和卵巢癌必须被视为PE的重要危险因素。本文讨论了恶性疾病中血栓形成事件的潜在相关机制、临床表现、诊断意义以及TE的治疗方面。
