肺癌与高血凝状态的研究进展  

Research advances of lung cancer and thrombophilia

作　　者：徐澄澄[1] 付向宁[1] 

机构地区：[1]华中科技大学附属同济医院普胸外科,湖北武汉430030

出　　处：《中华肿瘤防治杂志》2010年第10期790-794,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:总结国内外关于肺癌与高血凝状态的相关研究进展。方法:应用Pubmed和CNKI期刊全文数据库检索系统,以"肺癌、高凝血状态和静脉血栓栓塞症"为关键词,检索1998-01～2009-12相关文献。纳入标准:1)流行病学;2)医源性危险因素;3)肺癌与高血凝状态的病理机制;4)高血凝状态的防治。根据纳入标准,符合分析的文献53篇。结果:肺癌在手术、放化疗等医疗措施的作用下,通过组织因子、肿瘤促凝素、凝血酶、细胞因子和血细胞以及纤溶和抗凝系统等异常引起患者的高血凝状态,诱发血栓事件,增加患者的死亡率。激活的凝血系统又可以促进肿瘤的生长转移,形成恶性循环。针对高凝机制的治疗如低分子肝素可以预防肺癌VTE等并发症的发生,同时已证明有抗肿瘤的作用,延长患者的生存期。结论:肺癌患者可在多种因素和多种机制作用下呈高血凝状态,而高血凝状态又通过多种途径影响患者的预后。研究肺癌和高凝血状态的关系,将有利于肺癌的综合治疗。OBJECTIVE：To summarize the research progression in lung cancer and thrombophilia.METHODS：By PubMed and CNKI retrieval system,with ＂lung neoplasms,thrombophilia,venous thromboembolism and low molecular weight heparin＂ as key words,literature on lung cancer and thrombophilia were retrieved from Jan.1998 to Dec.2009.Selecting standards：1）epidemiology;2）iatrogenic risk factors;3）pathogenesis;4）prevention and treatments.After that,53 papers out of them were finally analyzed and reviewed.RESULTS：Lung cancer contributes to hypercoagulability,which leads to thrombosis,increasing mortality.Many iatrogenic factors including surgery,radiotherapy and chemotherapy and so on take part in thrombophilia.Abnormal expression of tissue factor and cancer procoagulant,function of thrombin,cytokines,blood cells,fibninolytic and anticoagulation system activate the coagulation system of patients with cancer,which also promotes tumor progression and distant metastases,continuing the vicious cycle of tumor growth and activated coagulation system.Treatments,especially low molecular weight heparin,aiming at mechanisms of hypercoagulability,not only prevent VTE of lung cancer patients,but also have antitumor properties,which extend survival time.CONCLUSIONS：Many factors and mechanisms cause hypercoagulability of lung cancer patients who may have poor prognosis.Further research in lung cancer and thrombophilia benefits for combined therapy of lung cancer.

关 键 词：肺肿瘤 高血凝状态 静脉血栓栓塞症 低分子肝素 综述文献 

分 类 号：R734.2[医药卫生—肿瘤]