Division of Vascular Cardiology, Mayo Clinic, Rochester, MN, USA.
Division of Oncology and Palliative Care, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland.
Eur J Haematol. 2018 Jan;100(1):83-87. doi: 10.1111/ejh.12985. Epub 2017 Nov 13.
Testicular vein thrombosis (TVT) etiology, recurrence, and survival were compared with lower extremity deep vein thrombosis (DVT) in order to determine whether treatment guidelines for DVT could be applied to TVT.
An inception cohort of patients with confirmed TVT (January 1995-October 2015) was compared to a control group of patients with lower extremity DVT matched by age, gender, and diagnosis date.
Thirty-nine men with TVT were identified; 15 (38%) with isolated TVT. Left testicular vein was affected in 77% patients; there were no cases of bilateral TVT. Cancer was over twofold more common in TVT patients (59% vs 28%, P = .01). Most cancers (78%) involved organs in proximity to the testicular vein. Although TVT patients were less frequently treated with anticoagulants (49% vs 97%, P = .0001), recurrence rates were similar to DVT group (TVT 4.2 vs DVT 1.1 per 100 patient-years, P = .11). Despite higher cancer prevalence, survival rates were similar between groups (31% vs 28%; P = .34). Major bleeding events were rare (one patient per group).
Identifying TVT should prompt a search for a regional malignancy. Despite the high cancer prevalence and low utilization of anticoagulants, recurrent venous thrombosis and mortality rates are similar to DVT patients.
为了确定是否可以将下肢深静脉血栓形成（DVT）的治疗指南应用于睾丸静脉血栓形成（TVT），比较了 TVT 的病因、复发和生存率与下肢深静脉血栓形成的差异。
回顾性分析了 1995 年 1 月至 2015 年 10 月确诊为 TVT 的患者队列（TVT 组），并与年龄、性别和诊断日期相匹配的下肢 DVT 患者（对照组）进行比较。
共发现 39 例 TVT 患者，其中 15 例（38%）为孤立性 TVT。77%的患者左侧睾丸静脉受累，无双侧 TVT 病例。TVT 患者的癌症发病率是对照组的两倍以上（59%比 28%，P=0.01）。大多数癌症（78%）涉及靠近睾丸静脉的器官。尽管 TVT 患者接受抗凝治疗的比例较低（49%比 97%，P=0.0001），但复发率与 DVT 组相似（TVT 为每 100 患者年 4.2 例，DVT 为 1.1 例，P=0.11）。尽管癌症患病率较高，但两组的生存率相似（31%比 28%，P=0.34）。大出血事件罕见（每组各 1 例）。
发现 TVT 应提示寻找局部恶性肿瘤。尽管癌症患病率高且抗凝治疗使用率低，但复发性静脉血栓形成和死亡率与 DVT 患者相似。
