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Cancer and the prothrombotic state.
Gregory Y H Lip1, Bernard S P Chin, Andrew D Blann
1University Department of Medicine, City Hospital, Birmingham, UK. g.y.h.lip@bham.ac.uk
The Lancet. Oncology
|March 23, 2002
Summary
Cancer patients often develop a prothrombotic state due to tumor-induced coagulation abnormalities. This review explores the clinical signs of thrombosis in cancer and the underlying hypercoagulable mechanisms.
Area of Science:
- Oncology
- Hematology
- Thrombosis Research
Background:
- Cancer is frequently associated with a prothrombotic state.
- Tumors can induce abnormalities in Virchow's triad, predisposing to thrombus formation.
- The prothrombotic state in cancer ranges from asymptomatic coagulation changes to severe thromboembolism.
Purpose of the Study:
- To describe the clinical manifestations of thrombosis in cancer.
- To discuss the evidence supporting a hypercoagulable state in cancer patients.
- To highlight the need for further research into mechanisms, prognostic implications, and clinical quantification.
Main Methods:
- Review of clinical manifestations of thrombosis in cancer.
- Discussion of evidence for a prothrombotic state.
- Exploration of contributing factors like procoagulant factors, platelets, endothelium, blood flow, and angiogenesis.
Main Results:
- Cancer patients exhibit abnormalities in all three components of Virchow's triad.
- Tumors express or secrete procoagulant factors (e.g., tissue factor, cancer procoagulant).
- Increased platelet turnover/activity, endothelial damage, altered blood flow, and abnormal angiogenesis contribute to hypercoagulability.
Conclusions:
- A prothrombotic or hypercoagulable state is a recognized complication of cancer.
- Further research is essential to elucidate mechanisms and clinical implications.
- Quantifying hypercoagulability indices may hold prognostic and therapeutic value in cancer care.