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Phlebologie 2008; 37(03): 142-147
DOI: 10.1055/s-0037-1622224
Original Article
Schattauer GmbH

Tumor-induzierte Thrombophilie

Zellbiologische Grundlagen und klinischer AusblickTumour-induced thrombophiliaBiological basis and clinical outlookThrombophilie induite par un processus tumoralBases biologiques et corrélation clinique
T. Goerge
1   Klinik und Poliklinik für Hautkrankheiten, Universitätsklinikum Münster
,
St. W. Schneider
1   Klinik und Poliklinik für Hautkrankheiten, Universitätsklinikum Münster
› Author Affiliations
Further Information

Publication History

Eingegangen: 14 April 2008

angenommen: 14 April 2008

Publication Date:
04 January 2018 (online)

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Zusammenfassung

Bereits im späten 19. Jahrhundert wurde von Armand Trousseau die klinische Beobachtung beschrieben, dass Tumorpatienten gehäuft thromboembolische Ereignisse erleiden. Allerdings sind die molekularen Mechanismen, die für die Tumor-induzierte Thrombose verantwortlich sind, noch weitgehend unbekannt. Obwohl es einige molekulare Konzepte zur Aktivierung des Gerinnungssystems bei Tumorpatienten gibt, sind die genauen Mechanismen Gegenstand intensiver Forschung. Das Verständnis und die Zusammenhänge dieses Wechselspiels könnten neue therapeutische Optionen eröffnen. Zunehmend wird klar, dass Tumorpatienten, die eine Aktivierung des Gerinnungssystems (z. B. aufgrund einer Thromboembolie) aufweisen, eine verstärkte Tumorprogression zeigen. Daher korreliert eine Aktivierung des Gerinnungssystems mit einer verstärkten Metastasierung und schlechten Prognose unabhängig von weiteren thrombotischen Ereignissen. Um die Mechanismen der Tumor-induzierten Thrombophilie besser zu verstehen, ist es notwendig, Studien zu initiieren, die diese Zusammenhänge und ihre therapeutischen Optionen untersuchen.

Summary

The clinical observation of thrombotic events in cancer patients has been first described in the late 19th century by Armand Trousseau. However, the molecular mechanisms that link tumour and thrombosis are far from being understood. While molecular concepts of how activation of the coagulation system could occur in cancer patients are being proposed, the exact mechanisms underlying this phenomenon that might finally lead to therapeutic options are still matter of intensive research. Interestingly, it is getting more and more recognized, that tumour patients showing activation of the coagulation system are at a greater risk of tumour progression than those without signs of thrombotic activity. Therefore, activation of the coagulation cascade in tumour patients correlates with higher risk of tumour progression and fatality, even without a thrombotic event. Therefore, it is necessary to increase our understanding of tumour-induced thrombophilia and initiate studies that recognize this important fact.

Résumé

L’observation clinique d’événements thrombotiques chez des patients cancéreux a été faite pour la première fois au 19ème siècle par Armand Trousseau. Cependant les mécanismes moléculaires qui relient une tumeur cancéreuse à une thrombose sont loin d’être compris. Alors que des concepts moléculaires sont avancés pour expliquer l’activation de la coagulation chez les patients cancéreux, les mécanismes précis qui puissent expliquer ce phénomène menant finalement à une décision thérapeutique font toujours l’objet d’une recherche intensive. Il est intéressant de noter que l’on admet de plus en plus que les patients cancéreux qui montrent une activation du système de coagulation ont également un risque de progression tumorale plus grand que ceux qui sont dépourvus de signes d’une activité thrombotique. Ainsi, l’activation de la cascade de la coagulation chez des patients cancéreux est en corrélation directe avec un risque augmenté de progression tumorale fatale, même en l’absence d’un événement thrombotique. Ainsi, il est nécessaire d’accroître notre compréhension de la thrombophilie induite par les tumeurs et de développer des études qui reconnaissent cette réalité importante.

Schlüsselwörter

Gerinnung - Thrombophilie - Antikoagulation - Metastasierung

Keywords

Coagulation - thrombophilia - anticoagulation - tumour progression

Mots clés

Coagulation - thrombophilie - anticoagulation - tumeurs malignes métastatiques
 

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