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ISSN 2007-2783 (Print)
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2015, Number 3

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Residente 2015; 10 (3)

Prothrombotic state in cancer patients

Abitia-Castro JC, Agredano-Pérez S, Mariscal-Ramírez I, Ronquillo-Carreón C, Guadalupe Villa-Grajeda G, Nava-Zavala AH, Rubio-Jurado B

Language: Spanish
References: 38
Page: 166-172
PDF size: 221.94 Kb.


ABSTRACT

Neoplasms are a group of diseases generated by alterations in the mechanisms of growth, differentiation and cell death. They have clinical and epidemiological importance due to its incidence and mortality. Clinical and biological diversity of cancers depends primarily on the cellular origin and differentiation; these changes are the expression of molecular alterations that create a complex panorama of clinical, biochemical and morphological profiles. Cancer is associated with a hypercoagulable state and only some patients develop a thrombotic event. There are multiple factors that influence the incidence of thrombosis: advanced disease, presence of a central catheter, chemotherapy, type of tumor, surgery, among others. Biological elements related to this hypercoagulable state are: abnormalities of the vascular wall, blood flow and blood components (tissue factor, thrombin); activation of hemostasis and cell growth factors. Tumor cells perpetuate this state by the release of tissue factor, cancer procoagulant, proinflammatory cytokines, growth factors, cell activation, that generate biological mechanisms like: activation of coagulation, inflammation, thrombosis, tumor growth, migration, angiogenesis and tumor metastasis; these mechanisms are related to treatment response, progression and patient survival. The study of coagulation activity in suspected cases of thrombotic disease is performed conventionally with the D-dimer test that explores the fibrinolytic phase of coagulation. This test is routine for the study of deep vein thrombosis and pulmonary embolism. This should be evaluated in those patients associated with the presence of thrombosis or hypercoagulable state factors, the frequency of thrombosis determine the clinical impact as well as knowing the profile of biomarkers related to biological activation of the coagulation system, and correlate positivity and negativity of these with the clinical outcome. In our population, it is convenient to deepen the study of factors associated with thrombosis present and insist on proper risk stratification of thrombosis that allows an accurate way to propose preventive measures in primary and secondary form.


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