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Antiphospholipid Antibodies: From General Concepts to Its Relation with Malignancies

机译:抗磷脂抗体:从一般概念到与恶性肿瘤的关系

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Antiphospholipid syndrome (APS) is an adquired autoimmune pro-thrombotic disease characterized by arterial and/or venous thrombosis and/or fetal losses associated with the persistent presence of antiphospholipid antibodies (aPL) detectable by solid phase assays (anticardiolipin (aCL) and anti-β2 glycoprotein I, β2GPI) and/or functional coagulation test (lupus anticoagulant (LA)). Most patients with typical APS manifestations have the presence of one or more of conventional aPL, but, some patients might exhibit clinical features related with APS but with persistent negative determinations of “classic” aPL (seronegative APS). Expanding the network of autoantibodies in patients highly suspected of having APS but who have normal results from a conventional test using new antibodies (i.e., phosphatidylserine/prothrombin and β2GPI domain 1) would increase the diagnosis. Thrombosis is one of the leading causes of death among patients with cancer, representing up to 15% of all deaths. Cancer increases the risk of thrombosis and chemotherapy is further associated with a higher risk of thrombosis. In addition, aPL may contribute to an increased risk of thrombosis in patients with malignancies, although the levels do not seem to reflect their pathogenicity. Several malignancies, particularly hematological and lymphoproliferative malignancies, may indeed be associated with the generation of aPL but do not necessarily enhance the thrombophilic risk in these patients.
机译:抗磷脂综合症(APS)是一种自发性自身免疫性血栓形成疾病,其特征为动脉和/或静脉血栓形成和/或胎儿丢失,并伴有可通过固相检测法检测到的抗磷脂抗体(aPL)持续存在(抗心磷脂(aCL)和抗β2糖蛋白I,β2GPI)和/或功能性凝血试验(狼疮抗凝剂(LA))。大多数具有典型APS表现的患者都有一种或多种常规aPL的存在,但是,一些患者可能表现出与APS相关的临床特征,但对“经典” aPL(血清阴性APS)的测定一直持续阴性。在高度怀疑患有APS但通过使用新抗体(即磷脂酰丝氨酸/凝血酶原和β2GPI结构域1)进行常规测试可得到正常结果的患者中,扩大自身抗体的网络将增加诊断。血栓形成是癌症患者死亡的主要原因之一,占所有死亡的15%。癌症会增加血栓形成的风险,而化学疗法则与血栓形成的较高风险相关。此外,aPL可能导致恶性肿瘤患者血栓形成的风险增加,尽管该水平似乎并未反映其致病性。某些恶性肿瘤,尤其是血液学和淋巴增生性恶性肿瘤,的确可能与aPL的产生有关,但不一定会增加这些患者的血栓形成风险。

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