Department of Respiratory Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Clin Respir J. 2021 Jan;15(1):65-73. doi: 10.1111/crj.13270. Epub 2020 Sep 28.
Pulmonary embolism (PE) is a potentially fatal complication and its morbidity together with fatalness will further increase when in patients with malignant tumors. Fast and accurate early diagnosis of PE thus seems considerably important.
To explore the risk factors of lung cancer complicated with PE.
A retrospective cohort study consisted of 40 lung cancer patients with PE (PE group) and 60 lung cancer patients without PE (non-PE group) were analyzed.
The white blood cell (WBC) count, D-dimer and low-density lipoprotein (LDL) were higher in PE group than those in non-PE group (P < 0.05), whereas the arterial partial pressure of oxygen (PaO ) in PE group was lower than that in non-PE group (P < 0.05). Carcinoembryonic antigen (CEA) level between two groups also exhibited statistical difference (P < 0.05). Those lung adenocarcinoma patients with stages III and IV tumor, coupled with deep venous thrombosis (DVT), having experienced bevacizumab treatment or platinum-based chemotherapy more likely suffered from PE (P < 0.05). The multivariate analysis revealed that high D-dimer, chemotherapy, DVT, stages III to IV, adenocarcinoma were independent risk factors associated with PE (P < 0.05). The overall survival time of patients in case group was significantly shorter than that in the control group with a median survival duration being 10.5 months (95%CI, 8.95-12.05) and 16.8 months (95%CI, 14.62-18.98), respectively, (P < 0.01).
High D-dimer, chemotherapy, DVT, stages III to IV and adenocarcinoma might have a positive correlation with PE, meanwhile, PE always predicted a poor prognosis in lung cancer patients.
肺栓塞(PE)是一种潜在致命的并发症,当合并于恶性肿瘤患者时,其发病率和死亡率将进一步增加。因此,快速准确地早期诊断 PE 显得尤为重要。
探讨肺癌合并肺栓塞(PE)的危险因素。
回顾性队列研究纳入了 40 例肺癌合并 PE 患者(PE 组)和 60 例肺癌不合并 PE 患者(非 PE 组)。
PE 组的白细胞计数(WBC)、D-二聚体和低密度脂蛋白(LDL)高于非 PE 组(P<0.05),而动脉血氧分压(PaO )低于非 PE 组(P<0.05)。两组间癌胚抗原(CEA)水平也存在统计学差异(P<0.05)。III 期和 IV 期肿瘤伴深静脉血栓形成(DVT)、接受贝伐珠单抗治疗或铂类化疗的肺腺癌患者更易发生 PE(P<0.05)。多因素分析显示,D-二聚体升高、化疗、DVT、III 至 IV 期、腺癌是与 PE 相关的独立危险因素(P<0.05)。病例组患者的总生存时间明显短于对照组,中位生存时间分别为 10.5 个月(95%CI,8.95-12.05)和 16.8 个月(95%CI,14.62-18.98)(P<0.01)。
D-二聚体升高、化疗、DVT、III 至 IV 期和腺癌与 PE 呈正相关,同时,PE 总是预示肺癌患者预后不良。