Ravin Amy J, Edwards Robert P, A Krohn Marijane, Kelley Joseph R, Christopherson Wayne A, Roberts James M
Grace Hill Neighborhood Health Centers Inc., St. Louis, Missouri 63130, USA.
Obstet Gynecol. 2002 Dec;100(6):1285-9. doi: 10.1016/s0029-7844(02)02320-7.
To measure the strength of the association between the factor V Leiden mutation and venous thromboembolism in gynecologic oncology patients.
We conducted a case-control study of gynecologic cancer patients in a referral center who were group matched for demographics, tumor type, and treatment. The prevalence of the factor V Leiden mutation was determined in both cases and controls, and an odds ratio was calculated. The factor V Leiden mutation was detected using polymerase chain reaction amplification and nucleic acid restriction digest of deoxyribonucleic acid extracted from leukocytes.
Seventy-five patients were enrolled in the study. Seventy-four samples were available for analysis. There were no differences between the cases and controls with respect to age, race, body mass index, smoking, cancer type, high stage (III or IV) of cancer, or treatment modality. The odds ratio for having the factor V Leiden mutation in patients with venous thromboembolism was 0.3 (95% confidence interval 0.1, 1.7).
This study suggests that the factor V Leiden mutation is not associated with an increased risk of venous thromboembolism in gynecologic oncology patients. This contrasts with other studies showing a strong association between the factor V Leiden mutation and venous thromboembolism in cases of previously unexplained venous thromboembolism, and venous thromboembolism associated with other hypercoagulable states, such as pregnancy and oral contraceptive use. The risk of venous thromboembolism due to cancer outweighs the contribution of the factor V Leiden mutation.
测定妇科肿瘤患者中凝血因子V莱顿突变与静脉血栓栓塞之间的关联强度。
我们在一家转诊中心对妇科癌症患者进行了一项病例对照研究，这些患者在人口统计学、肿瘤类型和治疗方面进行了组间匹配。测定了病例组和对照组中凝血因子V莱顿突变的患病率，并计算了比值比。使用聚合酶链反应扩增和从白细胞中提取的脱氧核糖核酸的核酸限制性消化来检测凝血因子V莱顿突变。
75名患者纳入研究。74份样本可用于分析。病例组和对照组在年龄、种族、体重指数、吸烟、癌症类型、癌症高分期（III期或IV期）或治疗方式方面没有差异。静脉血栓栓塞患者中存在凝血因子V莱顿突变的比值比为0.3（95%置信区间0.1, 1.7）。
本研究表明，凝血因子V莱顿突变与妇科肿瘤患者静脉血栓栓塞风险增加无关。这与其他研究形成对比，其他研究显示在既往不明原因的静脉血栓栓塞病例以及与其他高凝状态（如妊娠和使用口服避孕药）相关的静脉血栓栓塞病例中，凝血因子V莱顿突变与静脉血栓栓塞之间存在强关联。癌症导致的静脉血栓栓塞风险超过了凝血因子V莱顿突变的影响。
