恶性淋巴瘤血栓形成的研究进展

静脉血栓栓塞（venous thrombolism，VTE）是恶性肿瘤患者第二致死原因，并且癌症患者是血栓栓塞的高发人群，其预防和治疗是非常重要的。肿瘤患者发生VTE的风险较非肿瘤患者至少增加7倍，而血液系统肿瘤并发VTE的概率则较非肿瘤患者增加28倍，严重影响了恶性淋巴瘤患者的预后和生活质量。恶性淋巴瘤患者并发VTE的机制和危险因素尚未明确，VTE的发生与组织因子、微粒以及基因的单核苷酸多态性相关。为了降低VTE发生率，预测可能发生VTE的高危患者是非常重要的，这些患者将会从血栓预防中受益，因此临床上急需一种简单有效的VTE风险评估模型，联合检测外周血中生物标记物可提高VTE诊断率。由于淋巴瘤患者发生出血的风险较高，导致血栓的治疗更加复杂。本文就恶性淋巴瘤患者发生VTE的流行病学、发病机制、预防和治疗的最新研究做一综述。 

Progress in the research on venous thromboembolism in malignant lymphoma

Venous thromboembolism (VTE) is the second leading cause of death and is a major cause of morbidity in patients with cancer. The prevention and the treatment of VTE are important. The risk of thrombosis among cancer patients is increaseds by seven times, but this risk may be 28 times higher in patients with hematological tumors. This increased risk seriously affects the quality of life and the prognosis of malignant lymphoma patients. However, the pathogenesis and risk factors for VTE in the lymphoma patients are not well well-defined. This study reveals that tissue factors, micro-particles, and single nucleotide polymorphisms of gene are associated with VTE. Therefore, the identification of patients with the highest risk of VTE is important to improve the diagnostic rate of VTE. These patients would benefit from thrombo-prophylaxis. We therefore need a simple and effectual risk assessment model for predicting the incidence rates of VTE. Moreover, peripheral blood biomarkers might improve the accuracy of the diagnosis. Patients with lymphoma have a high risk for hemorrhage, and receiving anticoagulant therapy is challenging for them. This review summarizes the current knowledge of the epidemiology, pathogenesis, prophylaxis, and treatment of VTE in patients with lymphoma.