肺癌合并静脉血栓栓塞症的临床特征及预后影响因素分析

目的:探讨肺癌合并静脉血栓栓塞症(venous thromboembolism,VTE)的临床特征、治疗模式、转归及影响因素.方法:选择2015年1月1日至2020年12月31日大连医科大学附属第一医院收治的肺癌患者5769例,筛选新发VTE患者,收集性别、年龄、吸烟史、临床分期、病理类型等临床资料,分析肺癌合并VTE...

Clinical characteristics and prognostic factors in patients with lung cancer complicated with venous thromboembolism

Objective: To explore the clinical characteristics, treatment mode, outcome and the risk factor in lung cancer patients with venous thromboembolism. Methods] 5769 cases of lung cancer patients from Jan 1, 2015 to Dec 31, 2020 in ourhospital were analyzed retrospectively, 76 cases of VTE were collected. Clinical data including sex, age, smoking history, histopathologic type, et al were collected. Results] The incidence of VTE in lung cancer patients was 1.3 %, the median age was 69 years, male 47.4 %, female 52.6 %, 28.9 % had smoking history, 25.0 % had surgical history, 69.7 % have basic disease, stage I ~ III 47.4 %, stage IV 52.6 % ; adenocarcinoma 76.3 %, drive gene mutation 18.4 %, ECOG score at diagnosis of lung cancer was 84.2 % at 0-2 points and 15.8 % at 3-4 points. The Khorana score at diagnosis in the middle-risk group accounted for 73.7 %, the high-risk group accounted for 7.9 %, and the high-risk group accounted for 13.2 %. 36.8 % were deep venous thrombosis, 32.9 % were pulmonary embolism, and 30.3 % were deep venous thrombosis combined with pulmonary embolism. D-dimer was 100~29900 ug / L, with a median of 4100 ug/L, 94.7% increased. 30.3 % of VTE occurred during tumor treatment. Nearly half of patients with VTE appeared within 90 days after surgery, and the risk was the highest within 30 days after surgery. More than half of patients with advanced lung cancer occured VTE within 9 months of diagnosis, especially within 3 months. 93.4 % received anticoagulant therapy, 93.4 % improved after treatment, and 6.6 % died due to VTE. The smoking history and ECOG score in the diagnosis of lung cancer were correlated with the outcome of VTE. Conclusion]: The risk of VTE in patients with lung cancer is high and the clinical characteristics are complex. It is necessary to pay attention to the prevention, evaluation and screening of VTE in perioperative and advanced metastatic patients.