The effect of phlebothrombosis on the condition of the muscle tissue of the lower extremity in oncopathology

Abstract

Modern research has shown that cancer patients are at high risk of thrombotic complications, which worsen the results of anticancer treatment and occupy one of the leading places among the causes of death. Deep vein thrombosis of the lower extremities, as well as pulmonary embolism is the most dangerous complication of the cancer process in the body. The pathogenesis of hemostasiological paraneoplasia is based on the activation of both coagulation and vascular-platelet coagulation, which is provided by:disruption of the structural integrity and functional stability of the vascular endothelium by the cells of the tumor and cytokines; activation of platelets, which subsequently leads to their increased adhesion and aggregation; synthesis of procoagulants and fibrinolysis inhibitors; procoagulant activity of tumor-associated macrophages and activated peripheral blood monocytes. The aim of the study was to evaluate the structural changes of striated muscles and endothelial cells of the hemomicrocirculatory tract in deep vein thrombosis of the lower extremities of cancer patients. In order to detect changes in the muscular tissues of the lower extremity in oncopathology, scientists from I.Ya. Gorbachevsky Ternopil National Medical University conducted a light-optical histological and polarization study of skeletal muscle necropsies that died of cardiopulmonary shock in cancer patients. As a result of the assessment of structural changes of striated muscles and endothelial cells of the hemomicrocirculatory tract in deep vein thrombosis of the lower extremities of cancer patients, polarization microscopy showed significant contractural changes against the background of dyscirculatory changes. Given that the muscles of the lower extremities play a significant role in ensuring venous hemodynamics due to their contractile ability, these changes can be considered an important complementary link in the pathogenesis of venous insufficiency in patients with cancer and development of thrombotic complications in them. It should be noted that in this process an important role belongs to endothelial dysfunction. It is the damage of endothelial cells and "exposure of the bagal membrane" is the initial phase in the violation of microcirculation with the development of venule dystonia, interstitial and perivascular edema. At colon cancer against the background of hemodynamic disturbances expressed by degenerative damages of endotheliocytes with their desquamation, plethora of venules with dystonia of their gleam, interstitial and perivascular hypostasis there are heterogeneous displays of remodeling which are characterized by striated and contractural changes, homogenization of sarcoplasm with myocytolysis. Keywords: phlebothrombosis, oncological process, cancer, thrombotic complications, skeletal muscle in thrombosis.