Shao Lei, Wang Zhe-Hai, Zuo Jian-Yun
Department of Oncology, Shandong Cancer Hospital, Jinan, Shandong, 250117, PR China.
Ai Zheng. 2009 Apr;28(4):416-9.
Pulmonary embolism (PE) is a common complication in lung cancer patients with a high misdiagnosis rate and high mortality. This study was to investigate the clinical characteristics, diagnosis and treatment approaches for lung cancer accompanied by PE, thus to improve the diagnosis and treatment efficacy of this disease.
Clinical manifestations, comorbid conditions, risk factors, laboratory (indirect) and imaging examinations (direct) and treatment methods of 23 lung cancer patients with PE were retrospectively analyzed.
Among the 23 patients, 14(60.87%) had hypoxemia, all (100%) had elevated serum D-dimer, 11 (47.83%) had characteristic changes in electrocardiogram. Ten out of 12 cases (83.33%) examined by computed tomography angiography were found filling defect in the pulmonary artery; all two case receiving isotope perfusion scanning were detected segmental perfusion defect in the lung; one case undergoing MRI was found segmental filling defect in the pulmonary artery; and one case was discovered the direct sign of PE by pulmonary arteriography. The medium survival time (MST) of five cases who received symptomatic treatment was 13 days, of four cases who received thrombolysis therapy was 22.5 days, of 12 cases who underwent anticoagulation and chemotherapy was 93 days, and of two cases who were only given anticoagulant therapy were 70 days and 189 days respectively.
Diagnosis of lung cancer accompanied by PE mainly depends on direct examinations. Thrombolysis and anticoagulation therapy are recommended for those patients. In addition, chemotherapy may also be considered.
