Risk Factors and Research Progress on Integrated Traditional Chinese and Western Medicine Treatment for Hypercoagulable State in Advanced Lung Cancer Patientss

Abstract

Patients with advanced lung cancer frequently exhibit varying degrees of coagulation abnormalities and a hypercoagulable state, which constitute an important pathological basis for cancer-associated thrombosis (CAT), particularly venous thromboembolism (VTE), and are closely associated with tumor progression, treatment interruption, impaired quality of life, and poor prognosis. The mechanisms underlying hypercoagulability in advanced lung cancer are complex and reflect the combined effects of tumor biology, host factors, and anticancer therapy. Modern medical research indicates that increased tumor tissue factor expression, inflammatory responses, platelet activation, vascular endothelial injury, formation of neutrophil extracellular traps, and specific tumor molecular characteristics can all promote activation of the coagulation system; advanced or metastatic disease, older age, prolonged immobilization, previous VTE, elevated platelet counts, chemotherapy, targeted therapy, immunotherapy, and central venous catheterization further increase thrombotic risk. Although traditional Chinese medicine (TCM) has no disease entity directly corresponding to “hypercoagulability,” its pathogenesis and clinical manifestations can be understood within categories such as “blood stasis,” “phlegm-stasis,” and “mass accumulation (Zheng Ji).” Blood stasis runs throughout the development and progression of advanced lung cancer and interacts with qi deficiency, yin deficiency, phlegm turbidity, qi stagnation, and cancer toxin. Some clinical studies suggest that modern coagulation markers such as D-dimer are associated with blood stasis syndrome and its concurrent patterns in advanced lung cancer, providing a basis for the objectification of TCM syndrome differentiation. Current Western medical prevention and treatment mainly rely on dynamic risk assessment, basic preventive measures, and individualized anticoagulation strategies using low-molecular-weight heparin and direct oral anticoagulants. TCM approaches mainly include supplementing qi and activating blood, regulating qi and activating blood, nourishing yin and activating blood, and resolving phlegm and dispelling stasis. Existing studies suggest that some blood-activating and stasis-resolving formulas may improve coagulation parameters, hemorheological status, and related symptoms; however, high-quality evidence for reducing clinically important endpoints such as symptomatic VTE, recurrent VTE, and mortality remains insufficient. Future studies should establish dynamic risk-assessment systems integrating clinical characteristics, tumor molecular features, coagulation biomarkers, and TCM syndromes, and conduct high-quality integrative Chinese-Western medicine research on the basis of standard anticoagulant therapy to achieve precise prevention and treatment of hypercoagulability in advanced lung cancer.