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霍拉纳评分:肺腺癌患者早期死亡率的新预测指标。

Khorana Score: Νew Predictor of Early Mortality in Patients With Lung Adenocarcinoma.

作者信息

Vathiotis Ioannis, Dimakakos Evangelos P, Boura Paraskevi, Ntineri Angeliki, Charpidou Andiani, Gerotziafas Grigoris, Syrigos Konstantinos

机构信息

1 Oncology Unit GPP, Sotiria General Hospital Athens School of Medicine, Athens, Greece.

出版信息

Clin Appl Thromb Hemost. 2018 Nov;24(8):1347-1351. doi: 10.1177/1076029618777153. Epub 2018 May 27.

Abstract

Venous thromboembolism (VTE) is a typical complication in patients with lung cancer. Khorana score is an established tool for thromboembolic risk stratification of ambulatory patients with cancer undergoing outpatient chemotherapy. The aim of this study was to evaluate the predictive value of the Khorana score for VTE and death in patients with lung adenocarcinoma during first-line or adjuvant chemotherapy. Medical records of 130 patients with lung adenocarcinoma receiving first-line or adjuvant chemotherapy were retrospectively studied during the time period June 2013 to May 2015. Venous thromboembolism occurred in 13 (10.0%) patients. Thromboembolic events were significantly correlated with reduced survival during treatment period (hazard ratio [HR]: 3.24; 95% confidence interval [CI]: 1.11-9.49; P = .032). The VTE rates did not present statistically significant difference between different Khorana score groups ( P = .96). In univariate analysis, the risk of death during treatment period (median: 16 weeks) was 3.75 times higher in high-risk versus intermediate-risk patients (HR: 3.75, 95% CI: 1.36-10.36; P = .001) and had 2.25 times higher per point increase in the Khorana score (HR: 2.25, 95% CI: 1.36-3.73; P = .002); the above results were also reproduced in multivariate analysis. Khorana score represents a valuable tool for identifying patients with cancer in low thromboembolic risk but does not preserve its predictive value for higher risk individuals. Khorana score is an independent risk factor for death in patients with lung adenocarcinoma receiving first-line or adjuvant chemotherapy.

摘要

静脉血栓栓塞症(VTE)是肺癌患者的一种典型并发症。Khorana评分是一种已确立的工具,用于对接受门诊化疗的癌症门诊患者进行血栓栓塞风险分层。本研究的目的是评估Khorana评分对肺腺癌患者在一线或辅助化疗期间发生VTE和死亡的预测价值。回顾性研究了2013年6月至2015年5月期间130例接受一线或辅助化疗的肺腺癌患者的病历。13例(10.0%)患者发生了静脉血栓栓塞症。血栓栓塞事件与治疗期间生存率降低显著相关(风险比[HR]:3.24;95%置信区间[CI]:1.11 - 9.49;P = 0.032)。不同Khorana评分组之间的VTE发生率无统计学显著差异(P = 0.96)。在单因素分析中,高危患者与中危患者相比,治疗期间(中位时间:16周)死亡风险高3.75倍(HR:3.75,95% CI:1.36 - 10.36;P = 0.001),且Khorana评分每增加1分,死亡风险高2.25倍(HR:2.25,95% CI:1.36 - 3.73;P = 0.002);多因素分析也得出了上述结果。Khorana评分是识别低血栓栓塞风险癌症患者的有价值工具,但对高风险个体不具有预测价值。Khorana评分是接受一线或辅助化疗的肺腺癌患者死亡的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e27/6714766/f190f3907d28/10.1177_1076029618777153-fig1.jpg

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