Gong C Y, Li Z W, Zhou D X, Yan H, Bao J, Ye R J, Cao Z L, Gao Z C, Mu X L
Pulmonary Department and Critical Care Unit, Peking University People's Hospital, Beijing 100044, China, #Department of Epidemiology and Biostatistics, Institute of Reproductive & Child Health, Peking University, Beijing 100191, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2016 Jun;39(6):454-8. doi: 10.3760/cma.j.issn.1001-0939.2016.06.010.
To seek risk factors of VTE in patients with lung cancer through analysis of clinical features of patients with lung cancer complicated with venous thromboembolism (VTE).
Retrospective investigation was performed on patients diagnosed with lung cancer and with complete clinical data who were hospitalized in Peking University People's Hospital from January 1, 2010 to December 31, 2014. According to the presence of symptomatic VTE, patients were distributed into two groups, VTE group and control group. Patients' clinical data and laboratory parameters were collected. Single factor analysis was applied to compare the differences between the two groups. t test or nonparametric test was applied for intragroup comparison of measurement data, and chi-square test was applied for the comparison of counting information. Logistic regression analysis was applied to explore risk factors of venous thromboembolism. For VTE patients with this diagnosis when they were hospitalized, D-dimer and PT were obtained after the occurrence of VTE, so D-dimer and PT were eliminated in the multiple factors analysis. SPSS 13.0 statistical software was applied for statistical management and analysis.
548 patients with lung cancer were include in the investigation, with male 357, female 191, average age of (63.8±10.9) years old, 46 patients in VTE group and 502 patinets in control group. According to the results of single factor analysis in gender, age, tumor pathologic type, tumor stage, WBC, Hb, PLT, CEA, ALT, FIB, D-dimer, PT, APTT, PT-INR, the tumor stage (χ(2)=14.177), CEA (t=2.129) and Hb (t=-2.424) were risk factors for lung cancer patients complicated with venous thromboembolism. Logistic regression analysis showed that tumor stage was the independent risk factor of lung cancer complicated with venous thromboembolism (OR 2.058, 95%CI 1.307-3.238, P=0.002) , and CEA (r=0.395, P<0.001) and Hb (r=-0.144, P=0.001) were associated with lung cancer stage. The area under the curve formed by D-dimer predicting VTE was 0.825 (95%CI 0.751-0.900, P<0.001).
Tumor stage is the only risk factor for lung cancer patients complicated with venous thromboembolism in the study. However, because this study is a retrospective study, other potential high risk factors causing VTE cannot be excluded.
通过分析肺癌合并静脉血栓栓塞症（VTE）患者的临床特征，探寻肺癌患者发生VTE的危险因素。
对2010年1月1日至2014年12月31日在北京大学人民医院住院治疗、诊断为肺癌且临床资料完整的患者进行回顾性调查。根据是否存在症状性VTE将患者分为两组，即VTE组和对照组。收集患者的临床资料和实验室参数。采用单因素分析比较两组间的差异。计量资料组内比较采用t检验或非参数检验，计数资料比较采用卡方检验。应用Logistic回归分析探寻静脉血栓栓塞症的危险因素。对于住院时确诊为VTE的患者，在VTE发生后检测D-二聚体和PT，因此在多因素分析中剔除D-二聚体和PT。采用SPSS 13.0统计软件进行统计管理与分析。
共纳入548例肺癌患者，其中男性357例，女性191例，平均年龄（63.8±10.9）岁，VTE组46例，对照组502例。根据性别、年龄、肿瘤病理类型、肿瘤分期、白细胞、血红蛋白、血小板、癌胚抗原、谷丙转氨酶、纤维蛋白原、D-二聚体、PT、活化部分凝血活酶时间、PT国际标准化比值的单因素分析结果，肿瘤分期（χ(2)=14.177）、癌胚抗原（t=2.129）和血红蛋白（t=-2.424）是肺癌合并静脉血栓栓塞症患者的危险因素。Logistic回归分析显示，肿瘤分期是肺癌合并静脉血栓栓塞症的独立危险因素（OR 2.058，95%CI 1.307-3.238，P=0.002），癌胚抗原（r=0.395，P<0.001）和血红蛋白（r=-0.144，P=0.001）与肺癌分期相关。D-二聚体预测VTE的曲线下面积为0.825（95%CI 0.751-0.900，P<0.001）。
本研究中肿瘤分期是肺癌合并静脉血栓栓塞症患者的唯一危险因素。然而，由于本研究为回顾性研究，不能排除其他导致VTE的潜在高危因素。
