恶性肿瘤与血液系统

Relationship between malignant disease and hemostatic system

血液高凝状态、血栓形成和恶性肿瘤之间存在一定生物学关系。恶性肿瘤中以产生黏液的腺癌伴发血栓栓塞症的几率最高。德国病理学家Virchow将恶性肿瘤伴发血栓形成的病理生理学机制归纳为Virchow三联征，即静脉血液瘀滞状态、血管损伤及血液成分的异常。肿瘤相关凝血的激活影响肿瘤生长、微血管形成和转移过程，反过来这些过程增加血栓形成几率。纤溶系统的激活亦促进肿瘤的浸润、增殖、微血管形成过程，其作用超过了纤溶系统受损造成的血液高凝状态。因此抗凝及针对凝血、纤溶系统各个环节的治疗可能影响肿瘤的生长和播散过程。

The biological association among prothrombotic state, thrombosis and malignant disease has long been described. Thromboembolism is not equally common in all types of cancer, the highest incidence is found in mucin-producing adenocarcinomas. The pathophysiologic mechanism of cancer complicating thrombosis was concluded by Germany pathologist Virchow as Virchow triad, that is stasis, vascular damage and abnormal blood constituent. The activated clotting system is involved in tumor growth, angiogenesis and metastasis which will in turn increase the incidence of thrombosis. The activated fibrinolytic system can also promote tumor invasion, proliferation and angiogenesis whose effect is more important in tumor progression than that of prothrombitic state induced by the impairment of fibrolytic system.