摘要
静脉血栓栓塞(VTE)是一种通常诊断为多因素的多因素病症,发病率高,发病率高达20%。 事实上,癌症患者由于其止血 - 凝血系统的变化,淤滞和血流减缓,内皮功能障碍,血管炎症和血小板活化而处于较高的前血栓形成状态。此外,几种癌症依赖性因素可以总结以引发VTE的第一次发作或在抗凝治疗过程中引起其复发。通过额外有利于诸如固定化,感染,手术或插入中心静脉导管的风险以及抗癌治疗,这种前血栓形成状况进一步恶化。此外,在二次预防环境中,抗凝治疗伴有出血并发症的高发生率。鉴于上述情况,理解和确定与癌症患者VTE发生率和临床结局相关的因素可能对预防和管理VTE可分配并发症(包括死亡)具有重要价值。与癌症相关的VTE的性别相关的差异尚未完全定义。许多针对这个问题的研究已经产生了错误/不均匀的标准偏见。 在本次审查中,我们通过报道最近文献中最重要的发现,分析了癌症患者VTE发生的潜在差异。 根据患者性别确定差异临床方法,可能会根据肿瘤VTE预防的算法促进定制和优化的个性化治疗选择的设计。
关键词: 静脉血栓栓塞,癌症,性别,VTE产生,VTE复发,血栓预防。
Current Medicinal Chemistry
Title:Gender Differences in Cancer-associated Venous Thromboembolism
Volume: 24 Issue: 24
关键词: 静脉血栓栓塞,癌症,性别,VTE产生,VTE复发,血栓预防。
摘要: Venous thromboembolism (VTE) is a commonly diagnosed multifactorial condition with significant morbidity and mortality, occurring in up to 20% of cancer patients. Indeed, patients with cancer are in a higher pro-thrombotic state due to alterations in their haemostatic- coagulative system, stasis and blood flow slowdown, endothelial dysfunction, vascular inflammation and platelet activation. Moreover, several cancer-dependent factors can sum up to trigger a first episode of VTE or to cause its recurrence in the course of anticoagulant treatment. Such a pro-thrombotic condition is further worsened by additional favoring risks such as immobilization, infection, surgery, or insertion of a central venous catheter, and anti-cancer therapy. Furthermore, in the secondary prevention setting, the anticoagulant therapy is accompanied by a high incidence of bleeding complications. Given the above, understanding and identifying the factors associated with the incidence and clinical outcome of VTE in cancer patients might be of great value in the prevention and management of VTEattributable complications, including death. Differences associated to gender on cancerrelated VTEs are not yet fully defined; many of the studies that addressed the question have been biased by erroneous/non homogeneous inclusion criteria. In the present review, we analyzed the potential differences in VTEs occurrence in cancer patients, by reporting the most significant findings in the recent literature. The identification of a differential clinical approach according to patient sex, might prompt the design of personalized treatment options tailored and optimized according to algorithms for oncological VTE prevention.
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Gender Differences in Cancer-associated Venous Thromboembolism, Current Medicinal Chemistry 2017; 24 (24) . https://dx.doi.org/10.2174/0929867323666161018144505
DOI https://dx.doi.org/10.2174/0929867323666161018144505 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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