Debourdeau Philippe, Farge-Bancel Dominique
Service de médecine interne oncologie, hôpital Desgenettes 108, boulevard Pinel 69275 Lyon.
Rev Prat. 2007 Apr 15;57(7):737-42.
The standardized incidence of cancer in patients with venous thromboembolism (VTE) is about 5%. This risk is higher in patients diagnosed with idiopathic, bilateral or recurrent VTE. The incidence of cancer is the highest within the first year after the VTE and approximately 40% of these cases are already metastatic when diagnosed. Among malignancies presenting with VTE as their first clinical manifestation, cancers from the pancreas, the stomach, the ovary, the lung, the brain or the liver are the most commonly identified. An extensive diagnostic work-up in all patients with unexplained VTE is not cost effective in terms of survival or of quality of life. Cancer screening should be guided by the results of complete clinical examination, blood count and chest X-ray.
静脉血栓栓塞症(VTE)患者的癌症标准化发病率约为5%。在诊断为特发性、双侧或复发性VTE的患者中,这种风险更高。VTE发生后的第一年癌症发病率最高,且约40%的此类病例在诊断时已发生转移。在以VTE作为首发临床表现的恶性肿瘤中,最常发现的是来自胰腺、胃、卵巢、肺、脑或肝脏的癌症。就生存或生活质量而言,对所有不明原因VTE患者进行广泛的诊断性检查并不具有成本效益。癌症筛查应以全面临床检查、血常规和胸部X线检查结果为指导。