Ebina Yasuhiko, Uchiyama Mihoko, Imafuku Hitomi, Suzuki Kaho, Miyahara Yoshiya, Yamada Hideto
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
Medicine (Baltimore). 2018 Jun;97(23):e11009. doi: 10.1097/MD.0000000000011009.
We aim to clarify the incidence of deep venous thrombosis (DVT) before treatment in women with ovarian cancer and identify risk factors for DVT.In this prospective study, 110 women underwent venous ultrasonography before cancer treatment and D-dimer levels were measured. We investigated factors predicting DVT by logistic regression.DVT was detected in 25 of 110 women (22.7%) and pulmonary thromboembolism was coexisted in 2 women (1.8%). A total of 21 women (84.4%) with DVT were asymptomatic. D-dimer levels in women with DVT (median, 10.9; range, <0.5-98.2 μg/mL) were significantly higher than those in women without DVT (2.0; <0.5-60.8 μg/mL; P < .01). When 10.9 μg/mL was used as a cutoff value for D-dimer levels to predict DVT, specificity, sensitivity, and positive and negative predictive values were 92.9%, 52.0%, 68.4%, and 86.8%, respectively. The multivariate analysis demonstrated that D-dimer level (odds ratio [OR], 19.7; 95% confidence interval [CI], 5.89-76.76) and clear cell histology (OR, 7.1; 95% CI, 2.12-25.67) were independent factors predicting DVT.Asymptomatic DVT occurred with great frequency before treatment in patients with ovarian cancer. High D-dimer level and clear cell pathology is associated with a higher DVT risk.
我们旨在阐明卵巢癌女性患者治疗前深静脉血栓形成（DVT）的发生率，并确定DVT的危险因素。在这项前瞻性研究中，110名女性在癌症治疗前接受了静脉超声检查，并检测了D-二聚体水平。我们通过逻辑回归分析研究了预测DVT的因素。110名女性中有25名（22.7%）检测出DVT，2名女性（1.8%）同时存在肺血栓栓塞。共有21名（84.4%）发生DVT的女性无症状。发生DVT的女性D-二聚体水平（中位数为10.9；范围为<0.5-98.2μg/mL）显著高于未发生DVT的女性（2.0；<0.5-60.8μg/mL；P<0.01）。以10.9μg/mL作为D-二聚体水平预测DVT的临界值时，特异性、敏感性、阳性预测值和阴性预测值分别为92.9%、52.0%、68.4%和86.8%。多因素分析表明，D-二聚体水平（比值比[OR]为19.7；95%置信区间[CI]为5.89-76.76）和透明细胞组织学类型（OR为7.1；95%CI为2.12-25.67）是预测DVT的独立因素。卵巢癌患者治疗前无症状DVT的发生率很高。高D-二聚体水平和透明细胞病理与较高的DVT风险相关。
