肺癌合并肺栓塞危险因素的Meta分析

目的系统评价肺癌合并肺栓塞的相关危险因素。方法计算机检索PubMed、Embase、中国知网、万方等数据库,收集有关肺癌合并肺栓塞危险因素的文献,检索时限均为建库至2021年1月。由2名研究人员独立进行文献筛选、资料提取以及文献质量评价,并采用RevMan5.4软件和Stata16.0软件对纳入的数据进行Meta分析。结果共纳入25项研究,共3480例。Meta分析研究结果显示,肺癌患者发生肺栓塞的危险因素包括腺癌(OR=2.06,95%CI:1.75~2.44,P<0.01)、肿瘤分期(Ⅲ~Ⅳ期)(OR=2.67,95%CI:2.19~3.26,P<0.01)、化疗(OR=2.69,95%CI:2.08~3.47,P<0.01)、深静脉置管(OR=2.66,95%CI:1.68~4.19,P<0.01)、白蛋白<30 g/L(OR=6.65,95%CI:2.91~15.18,P<0.01)、D二聚体>500 mg/L(OR=5.87,95%CI:2.12~16.27,P<0.01)、白细胞>11×10^(9)/L(OR=8.26,95%CI:4.50~15.13,P<0.01)及慢性阻塞性肺疾病(OR=1.51,95%CI:1.16~1.95,P<0.01)。结论本研究显示腺癌、肿瘤分期(Ⅲ~Ⅳ期)、化疗、深静脉置管、白蛋白<30 g/L、D二聚体>500 mg/L、白细胞>11×10^(9)/L及慢性阻塞性肺疾病是肺癌患者发生肺栓塞的危险因素。受纳入研究数量及质量的限制,需更多高质量文章进一步加以验证。

Risk factors of lung cancer with pulmonary embolism:a meta-analysis

Objective To evaluate the risk factors of lung cancer with pulmonary embolism systematically. Methods By January 2021, pertinent literature on risk factors of lung cancer with pulmonary embolism were included form PubMed, Embase, CNKI, Wanfang database and others. Two researchers independently completed the literature screening, data extraction and quality evaluation of the included literature. RevMan5.4 software and Stata16.0 software were used to conduct meta-analysis. Results A total of 25 studies involving 3480 patients were included. Meta-analysis results show that the risk factors of pulmonary embolism in patients with lung cancer include adenocarcinoma (OR =2.06, 95% CI [1.75, 2.44], P <0.01), tumor stage (stage Ⅲ-Ⅳ)( OR =2.67, 95% CI [2.19, 3.26], P <0.01), chemotherapy (OR =2.69, 95% CI [2.08, 3.47], P <0.01), deep vein catheterization (OR =2.66, 95% CI [1.68, 4.19], P<0.01), albumin<30 g/L(OR=6.65, 95% CI [2.91, 15.18], P<0.01), D dimer>500 g/L (OR =5.87, 95% CI [2.12, 16.27], P <0.01), white blood cells >11×10⁹/L(OR =8.26, 95% CI [4.50, 15.13], P <0.01) and chronic obstructive pulmonary disease(OR =1.51, 95% CI [1.16, 1.95], P <0.01). Conclusion The risk factors for pulmonary embolism with lung cancer are adenocarcinoma, tumor staging (stage Ⅲ-Ⅳ), chemotherapy, deep venous catheterization, albumin <30 g/L, D-dimer >500 ng/mL, white blood cell >11×10⁹/L and chronic obstructive pulmonary disease(COPD). Due to limited quality and quantity of the included studies, more high-quality articles are needed to verify the conclusions.