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- Title
ПРОМЕНИ В КОАГУЛАЦИЯТА И ФИБРИНОЛИЗАТА ПРИ ЗЛОКАЧЕСТВЕНИ ЗАБОЛЯВАНИЯ.
- Authors
Стоенчева, Снежана; Попов, Веселин; Грудева-Попова, Жанет; Денева, Таня
- Abstract
Malignant diseases occupy a large part in human pathology. According to the World Health Organization, they are the second leading cause of death in developed countries, giving way only to cardiovascular diseases. In 2020, more than 10 million people worldwide died from malignant diseases. In men, carcinoma of the lung, prostate, stomach, rectum and colon are most common. In women, breast cancer is the most common, followed by carcinoma of the skin and cervix. A common complication in cancer patients is thrombosis. Despite the fact that venous thromboembolism is a major problem in patients with tumor diseases, studies of the prothrombotic state in these patients have been neglected. More than 130 years ago, the relationship between carcinogenesis and blood coagulation disorders was established. Abnormalities in coagulation status are found in up to 50% of all patients with malignant diseases and up to 90% of those with metastases. Thrombosis is the second most common cause of death in these patients. Clinical symptoms of coagulation disorders are very often the first sign of malignancy. Tumor growth, procoagulant properties of tumor and inflammatory cells, neoangiogenesis, vascular-endothelial dysfunction are some of the causes for thrombogenesis in patients with malignant diseases. The impaired function of the affected organ, decreased coagulation inhibitors, disturbed balance between the systems of coagulation and fibrinolysis also play important role in the pathogenetic mechanism of thrombosis. The application of chemotherapeutic drugs can also lead to disorders in hemocoagulation. Thus, coagulopathy and angiogenesis in the presence of malignancy actually appear to be anatomically and functionally related. They predispose cancer patients to an increased risk of thrombotic events or bleeding complications. Changes in laboratory parameters that indicate activation of coagulation and fibrinolysis such as fibrinogen, thrombin-antithrombin complex (TAT), tissue factor (TF), prothrombin fragment (F1+2), Antithrombin III (AT III), D-dimer and tissue plasminogen activator (t-PA) have been of increasing interest over the last decade in this pathology. The study of indicators of coagulation activation and fibrinolysis together with routine hemostasis tests in patients with malignant pathology would allow finding a marker or a complex of markers that best reflects changes in the hemostasis system and the risk of thrombotic events. This might be helpful not only to assess the thrombogenic risk, but also for diagnose, treatment and prevention of thrombotic complications such as deep venous thrombosis or pulmonary embolism. Cancer patients are at increased risk of thrombosis and furthers studies need to be performed in order to assess the need of antithrombotic prophylaxis.
- Publication
Knowledge: International Journal, 2023, Vol 56, Issue 3, p265
- ISSN
2545-4439
- Publication type
Article