Department of Medicine, St Rita's Medical Center, Lima, OH, USA.
Cancer Manag Res. 2013 Jul 26;5:165-78. doi: 10.2147/CMAR.S47094. Print 2013.
Thromboembolic events are important causes of morbidity and mortality in cancer patients. Clinical presentation in a community-based setting has not been fully clarified. The purpose of this study was to evaluate the incidence, risk factors, role of thrombophilia, and subsequent survival following thrombosis in cancer patients.
A retrospective review was undertaken of clinical data for all consecutive patients with histologically confirmed cancer seen by the author at a regional cancer center, with emphasis on cancer-related thrombosis.
Between 2005 and 2012, of 1874 cancer patients, 307 (16.4%) developed thrombosis during their lifetime. Of these patients, 37 (2%) had a history of thrombosis, while the remaining 270 (14.4%) patients developed thrombosis 3 months before or any time after diagnosis of cancer, which was considered to be cancer-related. These patients included 230 (12.3%) with venous thrombosis, 28 (1.5%) cases with arterial occlusion, and 12 (0.6%) with combined venous and arterial thrombosis. Patients of Caucasian ancestry were more prone to develop thrombosis, with a higher frequency of multiple genetic thrombophilia compared with other ethnic groups. In regression analysis, only advanced stages of cancer and the presence of atherosclerosis were predictive of thrombosis. There were no significant differences between venous and arterial thrombosis. The worst survival was noted in patients who developed thrombosis 3 months prior to or shortly after their diagnosis of cancer. There has been a recent improved survival outcome following therapy.
In addition to venous thrombosis, arterial occlusion with stroke and anginal symptoms is relatively common among cancer patients, especially those of Caucasian ancestry, and is possibly related to genetic predisposition.
血栓栓塞事件是癌症患者发病率和死亡率的重要原因。在社区环境下的临床表现尚未完全阐明。本研究的目的是评估癌症患者血栓形成的发生率、危险因素、血栓形成倾向的作用以及随后的生存情况。
对作者在一个地区癌症中心就诊的所有经组织学证实的癌症连续患者的临床数据进行回顾性分析，重点是癌症相关的血栓形成。
在 2005 年至 2012 年期间，1874 例癌症患者中有 307 例（16.4%）在其一生中发生血栓形成。在这些患者中，37 例（2%）有血栓形成史，而其余 270 例（14.4%）患者在诊断癌症前 3 个月或任何时间后发生血栓形成，被认为与癌症相关。这些患者包括 230 例（12.3%）静脉血栓形成、28 例（1.5%）动脉闭塞和 12 例（0.6%）静脉和动脉血栓形成。白种人患者更容易发生血栓形成，与其他种族相比，多发性遗传性血栓形成倾向的频率更高。在回归分析中，只有癌症的晚期和动脉粥样硬化的存在是血栓形成的预测因素。静脉血栓形成和动脉血栓形成之间没有显著差异。在诊断癌症前 3 个月或不久后发生血栓形成的患者的生存最差。最近治疗后生存结果有所改善。
除了静脉血栓形成外，动脉闭塞伴中风和心绞痛症状在癌症患者中也相对常见，尤其是白种人患者，可能与遗传易感性有关。
