癌症患者非创伤性脂肪栓塞与脂肪栓塞综合征(FES)的关系

IF 2.9 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Beáta Ágnes Borsay, Barbara Dóra Halasi, Zoltán Hendrik, Pórszász Kristóf Róbert, Katalin Károlyi, Teodóra Tóth, Péter Attila Gergely
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引用次数: 0

摘要

背景:脂肪栓塞和脂肪栓塞综合征是罕见的,但众所周知的后果长骨骨折和骨科手术。这些来源支持它们发展的力学理论。另一方面,作为生化理论提出的另一种途径,脂肪酶激活和脂肪分解也可能是脂滴在血管中出现的背景。根据Hulman的理论,升高的c反应蛋白水平可以促进非常低密度蛋白质的钙依赖性凝集和乳糜微粒形成脂肪球。这种急性期蛋白的水平主要在晚期癌症中增加,但在治疗成功方面也具有预测或指示价值。方法:本研究重点是严格选择不同组织学类型和癌症来源的患者,以及约90%的晚期癌症患者。收集组织样本后,冷冻切片用油红O染色检测脂肪栓塞。结果:不到50%的病例表现为点状、非临床相关的肺脂肪栓塞,无一例为脂肪栓塞综合征。在一个非晚期癌症病例中,观察到点状肾脂肪栓塞。结论:患者的临终无能状态可能影响手术。在骨转移的情况下,由于髓内窦受到影响,机械和生化背景都可能占主导地位,并介导脂肪栓塞的形成。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Relationship Between Non-Traumatic Fat Embolism and Fat Embolism Syndrome (FES) in Patients with Cancer.

Background: Fat embolism and fat embolism syndrome are rare but well-known consequences of long bone fractures and orthopedic surgeries. These sources support the mechanical theory of their development. On the other hand, as an alternative pathway suggested by the biochemical theory, lipase activation and fat breakdown are also a possible background for lipid droplets appearing in the vasculature. According to Hulman's theory, elevated C-reactive protein levels can facilitate calcium-dependent agglutination of very low-density proteins and chylomicrons forming fat globules. The level of this acute-phase protein can increase mainly in advanced-stage cancers but also has predictive or indicative value in treatment success.

Methods: This study focused on strictly selected patients with different histological types and origins of cancer, as well as advanced cancer in approximately 90% of the deceased. After collecting the tissue samples, the frozen sections were stained with Oil Red O to detect fat emboli.

Results: Less than 50% of the cases showed punctiform, non-clinically relevant pulmonary fat embolism, and fat embolism syndrome was identified in none of the cases. In one, non-advanced cancer case, punctiform kidney fat embolism was observed.

Conclusions: The end-of-life anergic state of patients may influence the procedure. In the case of osseous metastases, since the intramedullary sinuses are affected, both the mechanical and the biochemical backgrounds may prevail and mediate fat embolism formation.

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