Guo Jian, Deng Qin-Fang, Xiong Wei, Pudasaini Bigyan, Yuan Ping, Liu Jin-Ming, Zhou Cai-Cun
Soochow University, Suzhou, China.
Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Clin Respir J. 2019 Sep;13(9):574-582. doi: 10.1111/crj.13060. Epub 2019 Aug 7.
Venous thromboembolism (VTE) because of lung cancer has been sufficiently studied, nevertheless, little is known regarding the discrepancy of clinical characteristics and predictive factors among different presentations of VTE because of lung cancer.
This study was designed to investigate the distinction of clinical characteristics and predictive factors among different presentations of VTE because of lung cancer.
All patients concomitant lung cancer and VTE were stratified into three groups: pulmonary embolism (PE) group in which patients had sole PE, deep vein thrombosis (DVT) group with sole DVT and concomitance group with both PE and DVT.
Concomitance of PE and DVT (28.2 days) mostly occurred at the early stage after the diagnosis of lung cancer, by contrast with DVT (63.6 days) which did at the latest stage, whereas PE (36.7 days) generally developed intermediately in between (P = .02). In a Kaplan-Meier analysis, the cumulative survival rate of DVT group was higher than that of concomitance group, whereas the rate of PE group lied in between. (P = .002) The strongest correlated factors with the development of DVT, PE and concomitance were adenocarcinoma (HR 3.27, P = .003), chemotherapy (HR 2.62, P = .005) and D-Dimer (HR 3.88, P < .001), respectively. The strongest correlated factors with the mortality of DVT, PE and concomitance were comorbidity (HR 2.32, P = .003), metastasis (HR 3.12, P < .001), and metastasis (HR 4.29, P < .001), respectively.
Concomitance of DVT and PE represents the severest state of lung cancer, the earliest occurrence of VTE, and the worst survival rate, whereas DVT stands for the mildest condition of lung cancer and stablest pattern of VTE.
肺癌所致静脉血栓栓塞症(VTE)已得到充分研究,然而,对于肺癌所致VTE不同表现形式之间临床特征及预测因素的差异知之甚少。
本研究旨在调查肺癌所致VTE不同表现形式之间临床特征及预测因素的差异。
所有合并肺癌和VTE的患者被分为三组:单纯肺栓塞(PE)组、单纯深静脉血栓形成(DVT)组和同时合并PE与DVT的合并组。
PE与DVT合并出现(28.2天)大多发生在肺癌诊断后的早期,相比之下,DVT(63.6天)最晚出现,而PE(36.7天)一般出现在两者之间(P = 0.02)。在一项Kaplan-Meier分析中,DVT组的累积生存率高于合并组,而PE组的生存率介于两者之间(P = 0.002)。与DVT、PE及合并症发生最相关的因素分别是腺癌(HR 3.27,P = 0.003)、化疗(HR 2.62,P = 0.005)和D-二聚体(HR 3.88,P < 0.001)。与DVT、PE及合并症死亡最相关的因素分别是合并症(HR 2.32,P = 0.003)、转移(HR 3.12,P < 0.001)和转移(HR 4.29,P < 0.001)。
DVT与PE合并出现代表肺癌最严重的状态、VTE最早出现以及最差的生存率,而DVT代表肺癌最轻微的状态和最稳定的VTE模式。