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引用次数: 0
摘要
弥散性血管内凝血(DIC)是一种与癌症相关的副肿瘤综合征。实体癌通常表现为慢性DIC的临床形式,其中高凝激活引起的血小板减少与骨髓中血小板产生在较长时间内保持平衡。某些播散性癌症也表现为快速发作的严重DIC。此外,作为一种癌症相关血栓(CAT), DIC以高凝状态为特征,经常导致病理性血栓形成,如深静脉血栓形成、肺栓塞或脑梗死。如果DIC没有得到及时和适当的诊断和治疗,它会显著恶化癌症患者的预后和生活质量。因此,在实体癌的常规临床治疗中考虑DIC是必要的。本文根据日本血栓与止血学会(Japanese Society on Thrombosis and止血)最近发布的《日本2024年DIC管理临床实践指南》,对DIC合并实体癌的发病机制、诊断方法、治疗方法和原则进行综述。
[Disseminated intravascular coagulation associated with solid cancers].
Disseminated intravascular coagulation (DIC) is a cancer-associated paraneoplastic syndrome. Solid cancers typically present with a clinical form of chronic DIC in which thrombocytopenia due to hypercoagulable activation is balanced with platelet production in the bone marrow over an extended period. Certain disseminated cancers also present with rapid-onset, severe DIC. Additionally, as a cancer-associated thrombosis (CAT), DIC is characterized by a hypercoagulable state, frequently leading to pathological thromboses such as deep vein thrombosis, pulmonary embolism, or cerebral infarction. If DIC is not diagnosed and treated promptly and appropriately, it can significantly worsen prognosis and quality of life in cancer patients. Therefore, it is essential to consider DIC during the routine clinical management of solid cancers. This review discusses the pathogenesis of DIC associated with solid cancers, as well as diagnostic methods and treatment methods and principles based on the recently published Clinical Practice Guidelines for management of DIC in Japan 2024 by the Japanese Society on Thrombosis and Hemostasis.