Cancer-associated thrombosis: an overview.
Cancer-associated thrombosis: an overview.
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DOI：
10.4137/cmo.s18991
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Bukhary E
中科院分区：
文献类型：
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作者：
Elyamany G;Alzahrani AM;Bukhary E
静脉血栓栓塞症(VTE)是恶性肿瘤患者的常见并发症。新出现的数据增强了我们对癌症相关血栓形成的理解，这是癌症患者发病率和死亡率的主要原因。除VTE外，动脉闭塞伴中风和心绞痛症状在癌症患者中相对常见，可能与遗传易感性有关。在癌症患者中，静脉血栓形成的几个危险因素通常是同时存在的，包括手术、入院和固定、留置中心导管、化疗、红细胞生成刺激剂(ESA)的使用以及抗血管生成药物等新的分子靶向治疗。VTE的有效预防和治疗降低了发病率和死亡率，提高了生活质量。低分子肝素(LMWH)是预防和治疗VTE的有效、安全的首选手段。它已在很大程度上取代了普通肝素(UFH)和维生素K拮抗剂(VKA)。近年来，直接抑制凝血因子Xa或凝血酶的新型口服抗凝剂(NOAC)的开发是预防和治疗VTE的里程碑式的成就。这篇综述将集中于癌症相关血栓形成的流行病学和病理生理学、危险因素和新的预测VTE的生物标志物，并根据已发表的指南讨论癌症VTE的新的预防和治疗方案。
Venous thromboembolism (VTE) is a common complication in patients with malignant disease. Emerging data have enhanced our understanding of cancer-associated thrombosis, a major cause of morbidity and mortality in patients with cancer. In addition to VTE, arterial occlusion with stroke and anginal symptoms is relatively common among cancer patients, and is possibly related to genetic predisposition. Several risk factors for developing venous thrombosis usually coexist in cancer patients including surgery, hospital admissions and immobilization, the presence of an indwelling central catheter, chemotherapy, use of erythropoiesis-stimulating agents (ESAs) and new molecular-targeted therapies such as antiangiogenic agents. Effective prophylaxis and treatment of VTE reduced morbidity and mortality, and improved quality of life. Low-molecular-weight heparin (LMWH) is preferred as an effective and safe means for prophylaxis and treatment of VTE. It has largely replaced unfractionated heparin (UFH) and vitamin K antagonists (VKAs). Recently, the development of novel oral anticoagulants (NOACs) that directly inhibit factor Xa or thrombin is a milestone achievement in the prevention and treatment of VTE. This review will focus on the epidemiology and pathophysiology of cancer-associated thrombosis, risk factors, and new predictive biomarkers for VTE as well as discuss novel prevention and management regimens of VTE in cancer according to published guidelines.