Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA.
Mayo Clin Proc. 2011 Jan;86(1):25-30. doi: 10.4065/mcp.2010.0339.
To test active cancer for an association with venous thromboembolism (VTE) location.
Using the resources of the Rochester Epidemiology Project, we identified all Olmsted County, MN, residents with incident VTE during the 35-year period 1966-2000 (N = 3385). We restricted analyses to residents with objectively diagnosed VTE during the 17-year period from January 1, 1984, to December 31, 2000 (N = 1599). For each patient, we reviewed the complete medical records in the community for patient age, gender, and most recent body mass index at VTE onset; VTE event type and location; and previously identified independent VTE risk factors (ie, surgery, hospitalization for acute medical illness, active cancer, leg paresis, superficial venous thrombosis, and varicose veins). Using logistic regression we tested active cancer for an association with each of 4 symptomatic VTE locations (arm or intra-abdominal deep venous thrombosis [DVT], intra-abdominal DVT, pulmonary embolism, and bilateral leg DVT), adjusted for age, gender, body mass index, and other VTE risk factors.
In multivariate analyses, active cancer was independently associated with arm or intra-abdominal DVT (odds ratio [OR], 1.76; P = .01), intra-abdominal DVT (OR, 2.22; P = .004), and bilateral leg DVT (OR, 2.09; P = .02), but not pulmonary embolism (OR, 0.93).
Active cancer is associated with VTE location. Location of VTE may be useful in decision making regarding cancer screening.
检测活动性癌症与静脉血栓栓塞症(VTE)部位的关联。
利用罗切斯特流行病学项目的资源,我们在 1966 年至 2000 年 35 年间确定了所有奥姆斯特德县明尼苏达州的 VTE 新发病例居民(n=3385)。我们将分析限制在 1984 年 1 月 1 日至 2000 年 12 月 31 日期间有明确诊断的 VTE 的居民中(n=1599)。对于每例患者,我们在社区中查阅完整的病历,以了解患者的年龄、性别和 VTE 发病时的最新体重指数;VTE 事件类型和部位;以及先前确定的独立 VTE 危险因素(即手术、急性内科疾病住院、活动性癌症、腿部瘫痪、浅表静脉血栓形成和静脉曲张)。我们采用逻辑回归分析,校正年龄、性别、体重指数和其他 VTE 危险因素后,检测活动性癌症与 4 种症状性 VTE 部位(手臂或腹部深部静脉血栓形成[DVT]、腹部 DVT、肺栓塞和双侧腿部 DVT)的关联。
在多变量分析中,活动性癌症与手臂或腹部 DVT(比值比[OR],1.76;P=.01)、腹部 DVT(OR,2.22;P=.004)和双侧腿部 DVT(OR,2.09;P=.02)独立相关,但与肺栓塞(OR,0.93)无关。
活动性癌症与 VTE 部位有关。VTE 的部位可能有助于癌症筛查决策。