改良Wells评分对肺癌合并静脉血栓栓塞症的诊断价值

目的 评估改良Wells评分对肺癌合并静脉血栓栓塞症（VTE）的诊断价值。方法 选取住院的肺癌患者145例，评价Wells评分、血浆D 二聚体水平对肺癌合并VTE的诊断价值。结果 血浆D 二聚体诊断肺癌合并VTE的最佳截断值为2.51 mg/L，Wells评分诊断肺癌合并VTE的AUC为0.703［95%CI（0.621，0.776）］，Youden指数为0.407，最佳截断值为2分，其灵敏度为66.7%，特异度为74%；改良Wells评分诊断肺癌合并VTE的AUC为0.855［95%CI（0.787，0.908）］，Youden指数为0.543，最佳截断值为2分，其灵敏度为93.3%，特异度为61%。改良Wells评分与Wells评分在诊断肺癌合并VTE的AUC差异有统计学意义［Z=4.712，95%CI（0.088，0.215），P<0.05］。结论 改良Wells评分对肺癌合并VTE 具有较高的诊断价值。

Diagnostic value of modified Wells score in lung cancer complicated with venous thromboembolism

Objective To evaluate the diagnostic value of modified Wells score in lung cancer complicated with venous thromboembolism(VTE).Methods A total of 145 patients with lung cancer admitted to the hospital were selected. The diagnostic value of Wells score and plasma D dimer level in lung cancer with VTE were calculated.Results The optimal cut off value of plasma D dimer for the diagnosis of lung cancer with VTE was 2.51 mg/L. The AUC of Wells score for the diagnosis of lung cancer with VTE was 0.703（95%CI［0.621, 0.776］）, Youden index was 0.407, and the optimal cut off value was 2 points, with the sensitivity of 66.7% and the specificity of 74%. The AUC of the modified Wells score for the diagnosis of lung cancer with VTE was 0.855（95%CI［0.787，0.908］）, Youden index was 0.543 and the optimal cut off value was 2 points, with the sensitivity of 93.3% and the specificity of 61%. The difference of AUC between the modified Wells score and the Wells score in the diagnosis of lung cancer with VTE was statistically significant （Z=4.712，95%CI［0.088，0.215］，P<0.05）.Conclusion The modified Wells score is of high diagnostic value for lung cancer with VTE.