Bone marrow metastasis from advanced gastric cancer complicated with disseminated intravascular coagulation: a highly aggressive but manageable disease subtype

作者：Xiaohui Zhai, Caiqin Wang, Shanshan Li, Taiyuan Cao, Ge Du, Yan Zhang, Dianke Chen, Xinjuan Fan, Yan Huang, Ping Hu, Jian Zheng, Zuli Yang, Lei Lian, Junsheng Peng, Ping Lan, Jian Xiao · 发表于：癌症：英文版 · 年份：2022 · DOI：10.1002/cac2.12277 · 被引用次数：17 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Gastric Cancer Management and Outcomes、Lung Cancer Treatments and Mutations

Dear Editor, Gastric cancer (GC) is the fifth most commonly diagnosed cancer and the fourth cause of cancer-related death worldwide [1, 2]. It has a greater prevalence in Eastern Asia, compared to other parts of the world, whereby more than two-thirds of the cases are diagnosed as advanced gastric cancer (AGC) [3]. Disseminated intravascular coagulation (DIC) is a clinicopathologic syndrome characterized by laboratory evidence of platelets and clotting factors consumption, and proteolytic degradation. The occurrence of DIC in advanced stage diseases has been reported in several types of solid carcinomas but rarely reported in GC (∼1.6% in previous studies) [4]. AGC frequently presents with visceral metastasis to the liver and lung and less than 10% of the patients have bone metastasis [5]. The double occurrence of multiple bone marrow metastasis (BMM) and DIC in AGC is extremely rare. This type of AGC can be characterized as highly aggressive GC (HAGC) due to its highly aggressive biological behavior and very poor prognosis. Such cases are being increasingly recognized in clinical practice. During the past several decades, HAGC has been reported mainly in the form of case reports and mostly by Japanese researchers. Except for simultaneous DIC and systemic BMM of AGC, various clinical features have been scarcely described and a standard treatment has not yet been established. In this study, from a cohort of 964 AGC patients, 36 patients (3.73%) were observed to have double occ...