Thrombosis Disease And Blood Coagulation System Function In Patients With Lung Cancer Related Research Progress

Lung cancer is divided into small cell lung cancer and non-small cell lung cancer.It is one of the malignant tumor which can make a serious damage to human beings.Among all the cancers,lung cancer has the highest mortality of malignant tumors.Its morbidity and mortality rate has a rising trend year by year.Lung cancer patients are often with hypercoagulable state,and recent studies increasingly find coagulation dysfunction is the first sign of malignant tumors.The hypercoagulable state of lung cancer patients not only promoting thrombosis,developed thromboembolic disease,but also the cancer cells will not be Rupture of death own to the effect of shear stress.Instead,it may form cancer embolus which attached to platelets or vascular endothelium and attribute to the distant metastasis.The change of the index that the subclinical coagulation and fibrinolysis system in lung cancer patients is common.FIB is the major protein of coagulation process and it is one of the key indicators reflecting coagulation.According to reports in the literatures,the plasma FIB level in lung cancer patients with different periods is difference,there are 35% patients showed abnormal at early stage of tumor,whiel about 83% patients whose plasma FIB level significantly increased at late stage.Plasma D-dimer is a end products that fibrin degraded by plasmin.Its increase can be considered as a kind of molecular markers of fibrinolytic hyperfunction and high coagulation state,and it is the specific indexes of secondary increased fibrinolytic activity.For lung cancer patients there are many reasons lead to the elevate of plasma D-dimer level increase,so the value of meature plasma D-dimer level which result negative is far more than positive.If the result is negative we can exclude pulmonary embolism at a much greater extent,positive result as a tip that the high VTE risk and parents need a next examination for definitive diagnosis.Tumor patients often exist coagulation activation for the reasons of cancer itself or treatment measures,the typical representation are VTE and low level disseminated intravascular coagulation(DIC).For malignant tumor patients,the invasion and transform ablity of tumor is strong,tumor grow rapidly,the consumption of partial fibrinogen and platelet lead to the lack of generalized fibrinogen and platelet.So the presentation of DIC in malignant tumor patients is often bleeding.We should be on the alert about the risk of bleeding once patients suffered DIC.A large number of literature studies have showed that the increase of plasma D-dimer level and plasma FIB level have a close relationship to tumor metastasis,it means that plasma D-dimer level and plasma FIB level could be the reference designators for prognosis of lung cancer patients.According to the studay of Pavey,the plasma D-dimer level of metastasis group is significantly higher than the limited group,that indicate increased plasma D-dimer level can promote the metastasis.High level of plasma D-dimer can be a serum marker in patients with advanced lung cancer,and there is a positive correlation between plasma D-dimer level and clinical stage.VTE is a common complication in malignant tumor such as lung cacer,breast cancer or ovarian cancer,it is a essential lethal factor for tumor patients.As to non-small cell lung cancer the incidence of deep venous thrombosis is 13.6%.,chemotherapy promote the formation of hypercoagulable state and result in increased risk of VTE.That effected the treatment process,prolonging the hospitalization time,adding to the economy burden,what is more,it can influence the therapeutic effectiveness even lead to death.With regard to the patient with different pathological types and pathological stage,incidence rate of VTE is different.The incidence rate of non-small cell lung cancer is 1.5~2.1 times than small cell lung cancer,adenocarcinoma is 2~3 times than squamous carcinoma,while patient with distant metastasis is 4~6 times than those lesions limited.Examing the the plasma D-dimer level and the plasma FIB level of lung cancer patiens,diagnosing VTE and pulmonary embolism earlier and using anticoagulant to intervente treatment properly,it can make a significant sense for improving the prognosis,prolong life span and improve the quality of life.So studies on the relationships between lung cancer and coahulation system is of significant impact.This article makes a summary on the relationships between lung cancer and the diagnosis and prevention of thromboembolic disease and fibrinolytic system,the pathophysiology mechanismof coagulation system related components during the development process of the disease and its impact on disease.