Lung adenocarcinoma and antiphospholipid antibodies ★

Thrombosis is a frequent finding in cancer patients, being referred to as a poor prognostic factor. The mechanisms underlying the thrombophilic state in malignancy are not well elucidated but involve a complex interaction between tumor and host cells as well as the hemostatic system. A number of studies have demonstrated the presence of antiphospholipid antibodies (aPL) in cancer patients, suggesting a potential role in tumor-associated thrombosis. A prospective analysis has been performed in a group of lung adenocarcinoma patients in respect to the presence of aPL and thrombotic manifestations. Lupus anticoagulant (LAC) was identified in 61 out of 105 patients and it correlated highly with thrombosis (22/61, LAC positive vs 2/44, LAC negative RR = 7.93; p < 0.001). On the other hand, patients that displayed IgM anti-β2-glycoprotein I (aβ2GPI) (22/80) showed an unexpected decrease in thrombosis risk (2/22, with IgM aβ2GPI vs 18/58, without IgM aβ2GPI RR = 0.29; p = 0.04). Considerations on the mechanisms that link cancer, thrombosis and aPL are discussed in this article.