From Jane Ann Nohl Division of Hematology and Center for the Study of Blood Diseases, University of Southern California-Keck School of Medicine, Los Angeles, California.
J Natl Compr Canc Netw. 2014 Nov;12(11):1557-60. doi: 10.6004/jnccn.2014.0155.
Venous thromboembolism (VTE) is a frequent clinical complication of cancer and its treatment. Although much of the epidemiologic data regarding this complication have been based on symptomatic events, the use of multidetector row CT scanner technology has led to increased identification of VTE on scans ordered primarily for staging or restaging of malignancy. These incidentally discovered VTEs are variously referred to in the literature as incidental, asymptomatic, unexpected, or unsuspected VTE. A recent guidance paper by the Hemostasis and Malignancy Subcommittee of the International Society on Thrombosis and Haemostasis provided recommendations regarding this terminology (now termed incidental) and reporting of incidental VTE for clinical trials. A growing number of retrospective and case-controlled reports have described the prevalence, prognostic implications, and treatment options for these incidentally discovered VTE events, and have reported similar clinical outcomes for patients with incidental and symptomatic VTE. Because most reported patients with incidental VTE have been treated in a manner similar to those with symptomatic events, the present recommendations, except in rare circumstances, support the use of standard anticoagulation in the management of incidental deep vein thrombosis and pulmonary embolism.
静脉血栓栓塞症（VTE）是癌症及其治疗的常见临床并发症。尽管关于这一并发症的大部分流行病学数据都是基于有症状的事件，但多排螺旋 CT 扫描仪技术的应用导致了更多的 VTE 在主要用于分期或重新分期恶性肿瘤的扫描中被发现。这些偶然发现的 VTE 在文献中被不同地称为偶然的、无症状的、意外的或未被怀疑的 VTE。国际血栓形成和止血学会止血和恶性肿瘤小组委员会最近的一份指导文件就这一术语（现在称为偶然）和偶然 VTE 的临床试验报告提供了建议。越来越多的回顾性和病例对照报告描述了这些偶然发现的 VTE 事件的发生率、预后意义和治疗选择，并报告了偶然 VTE 和有症状 VTE 患者相似的临床结果。由于大多数报告的偶然 VTE 患者的治疗方式与有症状事件相似，除了在极少数情况下，目前的建议支持在管理偶然深静脉血栓形成和肺栓塞时使用标准抗凝治疗。
