Pathogenesis of Trousseau’s syndrome
Abstract
After the first observations A. Trousseau in 1865, it is exist a host of studies on the relationship between the pathogenesis of cancer and thrombosis. There is now no doubt that the cancer patients occur much more frequently thromboembolism, and migratory venous thrombosis is a manifestation of paraneoplastic syndrome in cancer patients. In general, any manifestation of thrombohemorrhagic complications in cancer patients called Trousseau’s syndrome. While thrombotic complications such as venous thromboembolism are most frequent in cancer patients, may also experience severe bleeding symptoms due to systemic coagulopathies, including disseminated intravascular coagulation, haemolytic thrombotic microangiopathy, and hyperfibrinolysis. The basis of the pathophysiology of Trousseau’s syndrome, except the classic triad of Virchow, is overproduction of tissue factor, the main initiator of extrinsic coagulation pathway. Thus a significant release of microparticles from tumor cells bearing tissue factor is critical not only for the formation of a blood clot, but the growth and progression of tumors. Tumor cells activate the coagulation cascade or fibrinolysis system, providing conditions for its further spread, stimulation of angiogenesis, increased vascular permeability, which in turn promotes metastasis
About the Authors
A. V. Vorobev
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation
MD, Ph.D., Associate Professor, Department of Obstetrics and Gynecology
Russian Federation
MD, Ph.D., Associate Professor, Department of Obstetrics and Gynecology
A. M. Chabrov
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation
MD, Ph.D., head of gynecological department
Russian Federation
MD, Ph.D., head of gynecological department
A. A. MD, Ph.D., head of gynecological department
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation
MD, Ph.D., gynecological department
Russian Federation
MD, Ph.D., gynecological department
S. V. Bulgakova
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation
MD, Ph.D., gynecological department
Russian Federation
MD, Ph.D., gynecological department
A. D. Makatsariya
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation
MD, corresponding member of the Russian Academy of Sciences, Professor, Head of the Department of Obstetrics and Gynecology
Russian Federation
MD, corresponding member of the Russian Academy of Sciences, Professor, Head of the Department of Obstetrics and Gynecology
References
1. Vorob'ev A.V. Status platelet hemostasis in patients with gynecological cancer. Proceedings of the VI Russian forum «Mother and Child» [Sostoyanie trombotsitarnogo zvena gemostaza u onkoginekologicheskikh bol’nykh. Materialy VI rossiiskogo foruma «Mat’ i ditya». (in Russian)]. 2004: 318-319.
2. Makatsariya A.D., Vorob’ev A.V., Bitsadze V.O. Malignancies, thrombophilia, thrombosis. Monograph [Zlokachestvennye novoobrazovaniya, trombofiliya, trombozy. Monografiya. (in Russian)]. Moscow. 2008; 650 s.
3. Russian clinical recommendations for diagnosis, treatment and prevention of venous thromboembolic complications. Phlebology Association of Russia, Russian Society of Surgeons [Rossiiskie klinicheskie rekomendatsii po diagnostike, lecheniyu i profilaktike venoznykh tromboembolicheskikh oslozhnenii. Assotsiatsiya flebologov Rossii, Vserossiiskoe obshchestvo khirurgov. (in Russian)]. Moscow. 2010
4. Tsyb A.F., Sushkevich G.N., Baluda M.V., Vorob'ev A.V., Chabrov A.M. The principles of prevention of thrombotic events in patients with cancer (solid education). Manual for physicians [Printsipy profilaktiki tromboticheskikh oslozhnenii u onkologicheskikh bol’nykh (solidnye obrazovaniya). Posobie dlya vrachei. (in Russian)]. Obninsk. 2008; 42 s.
5. Bharthuar A., Khorana A.A., Hutson A. et al. Circulating microparticle tissue factor, thromboembolism and survival in pancreaticobiliary cancers. Thromb Res. 2013; 132: 180-184.
6. Chaturvedi S., Sidana S., Elson R., Khorana A.A., McCrae K.R. Symptomatic and incidental venousthromboembolic disease are both associated withmortality in patients with prostate cancer. PLoSOne 2014; 9: e94048.
7. Claussen C., Rausch A.V., Spath B. et al. Clinical significance of hemostatic activation markers inwomen with suspected ovarian cancer. Oncol Res Treat. 2014; 37: 669.
8. Dammacco F., Vacca A., Procaccio P. et al. Cancer-related coagulopathy (Trousseau's syndrome): review of the literature and experience of a singlecenter of internal medicine. ClinExp Med 2013; 13: 85-97.
9. Davila M., Robles-Carrillo L., Unruh D. et al. Microparticle association and heterogeneity oftumor-derived tissue factor in plasma: is it important for coagulation activation? ThrombHaemost. 2014; 12: 186-196.
10. Demers M., Wagner D.D. NETosis: a new factor intumor progression and cancer-associated thrombosis. SeminThrombHemost. 2014; 40: 277-283.
11. Fuchs T.A., Brill A., Wagner D.D. Neutrophil extracellular trap (NET) impact on deep vein thrombosis. ArteriosclerThromb Vase Biol. 2012; 32: 1777-1783.
12. Geddings J.E., Mackman N. Tumor-derived tissuefactor-positive microparticles and venous thrombosisincancer patients. Blood. 2013; 122: 1873-1880.
13. Hernandez C., Orbe J., Roncal C. et al. Tissue factorexpressed by microparticles is associated withmortality but not with thrombosis in cancer patients. ThrombHaemost. 2013; 110: 598-608.
14. Hyman D.M., Soff G.A., Kampel L.J. Disseminatedintravascular coagulation with excessive fibrinolysis in prostate cancer: a case series and review ofthe literature. Oncology. 2011; 81: 119-125.
15. Khorana AA. Risk assessment for cancerassociated thrombosis: what is the best approach? Thromb Res. 2012; 129: 10-15.
16. Kitchens C.S. The contact system. Arch Pathol Lab Med. 2002 Nov; 126 (11): 1382-6.
17. Kocatiirk B., Versteeg H.H. Tissue factor isoformsin cancer and coagulation: may the best isoformwin. Thromb Res 2012; 129: 69-75.
18. Langer F., Bokemeyer C. Crosstalk between cancerand haemostasis. Implications for cancer biologyand cancer-associated thrombosis with focus ontissue factor. Hamostaseologie. 2012; 32: 95-104.
19. Lo L., Valentine H., Harrison J. et al. Tissue factorexpression in the metaplasia-adenomacarcinomasequence of gastric cancer in a European population. Br I Cancer. 2012; 107: 1125-1130
20. Mackman N. New insights into the mechanisms ofvenous thrombosis. J Clin Invest. 2012; 122: 2331-2336.
21. Rak J., Yu J.L., Luyendyk J., Mackman N. Oncogenes, trousseau syndrome, and cancerrelated changesin the coagulome of mice and humans. Cancer Res. 2006: 66: 10643-10646.
22. Sack G.H. Jr, Levin J., Bell W.R. Trousseau's syndrome and other manifestations of chronic disseminated coagulopathy in patients with neoplasms: clinical, pathophysiologic, and therapeuticfeatures. Medicine (Baltimore) 1977; 56: 1-37.
23. Thaler J., Preusser M., Ay C. et al. Intratumoral tissue factor expression and risk of venous thromboembolism in brain tumor patients. Thromb Res. 2013; 131: 162-165.
24. Thaler I., Ay C., Mackman N. et al. Microparticle-associated tissue factor activity in patients with pancreatic cancer: correlation with clinicopathologicalfeatures. Eur I Clin Invest. 2013; 43: 277-285.
25. Trousseau A. Phlegmasiaalbadolens. Clinique Medicale de l'Hotel-Dieu de Paris. 1865; 3: 654-712.
26. Varki A. Trousseaus syndrome: multiple definitions and multiple mechanisms. Blood. 2007; 110; 1723-1729.
27. Vorobiev A.V., Makatsaria A.D., Chabrov A.M. Thrombophilia markers in cancer patients during chemotherapy and radiation therapy. Pathophysiology of haemostasis and thrombosis. 2006; 35 (1-2): A20.
28. Van Doormaal F.K. Terpstra W., Van Der Griend Ret al. Is extensive screening for cancer in idiopathicvenous thromboembolism warranted? J ThrombHaemost. 2011; 9: 79-84.
For citation:
Vorobev A.V., Chabrov A.M., MD, Ph.D., head of gynecological department A.A., Bulgakova S.V., Makatsariya A.D. Pathogenesis of Trousseau’s syndrome. Obstetrics, Gynecology and Reproduction. 2015;9(2):99-109. (In Russ.) https://doi.org/10.17749/2070-4968.2015.9.2.099-109
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