Escalante Carmen P, Gladish Gregory W, Qiao Wei, Zalpour Ali, Assylbekova Binara, Gao Shuwei, Olejeme Kelechi A, Richardson Marsha N, Suarez-Almazor Maria E
Department of General Internal Medicine, Unit 1465, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Support Care Cancer. 2017 May;25(5):1571-1577. doi: 10.1007/s00520-016-3559-6. Epub 2017 Jan 9.
Venous thromboembolism (VTE) is a major complication of cancer with recent increasing reports of incidental VTE. The objectives are to estimate the prevalence of incidental VTE in cancer patients on staging CT scans, identify common symptoms, and determine VTE recurrence in a prospective study.
One thousand ninety patients were studied. Adult cancer patients scheduled for outpatient staging CT scans were eligible. VTE cases were followed for 6 months. Fisher's exact test for group comparisons of categorical variables and generalized linear modeling to estimate the prevalence of incidental VTE was used.
The mean age was 58 years (range 18-87 years); 50% were male. The prevalence of incidental VTE was 1.8% (CI 1.15-2.87%). Significant symptoms in patients with VTE included fatigue (p = 0.004), stress (p = 0.0195), depression (p = 0.019), poorer quality of life (p = 0.0194), and poorer physical well-being (p = 0.0007). All the patients with VTE had at least one comorbidity (p = 0.03). No patient had recurrence within 6 months.
The prevalence of incidental VTE on staging CT scans is lower than previously reported. Symptoms were associated with VTE; however, further work is needed to understand whether these are clinically relevant. No VTE recurrences were noted following 6 months.
静脉血栓栓塞症（VTE）是癌症的一种主要并发症，近期关于偶发性VTE的报道日益增多。本研究的目的是在一项前瞻性研究中，估计癌症患者在分期CT扫描时偶发性VTE的患病率，确定常见症状，并判断VTE的复发情况。
共研究了1090例患者。纳入计划进行门诊分期CT扫描的成年癌症患者。对VTE病例进行了6个月的随访。采用Fisher精确检验对分类变量进行组间比较，并使用广义线性模型估计偶发性VTE的患病率。
平均年龄为58岁（范围18 - 87岁）；50%为男性。偶发性VTE的患病率为1.8%（95%置信区间1.15 - 2.87%）。VTE患者的显著症状包括疲劳（p = 0.004）、压力（p = 0.0195）、抑郁（p = 0.019）、生活质量较差（p = 0.0194）以及身体状况较差（p = 0.0007）。所有VTE患者至少有一种合并症（p = 0.03）。6个月内无患者复发。
分期CT扫描时偶发性VTE的患病率低于先前报道。症状与VTE相关；然而，需要进一步研究以了解这些症状是否具有临床相关性。6个月后未观察到VTE复发。
