Decreased lung cancer survival with hormone-replacement therapy: caused by a decreased tissue factor pathway inhibitor level? Clinical Oncology

摘要

To the Editor: In the January 1,2006, issue of Journal of Clinical Oncology, Ganti et al reported decreased survival in women with lung cancer who used hormone-replacement therapy (HRT). In the Discussion section and the article's accompanying Editorial, several explanations of this finding were debated. We put forward the hypothesis that the observed decrease in lung cancer survival might be a result of the effects of HRT on the coagulation system, in particular on the endogenous coagulation inhibitor tissue factor pathway inhibitor (TFPI).HRT increases the risk of venous thromboembolic disease, partly because of reduced TFPI levels. Low levels of TFPI in circulating blood are associated with increased risk of venous thrombosis.