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肺癌高凝状态患者的临床特征及预后分析:一项单中心、回顾性、真实世界研究

Clinical characteristics and prognostic analysis of Lung Cancer patients with Hypercoagulability: A single-center, retrospective, real-world study.

作者信息

Ma Yunfei, Li Guangda, Li Xiaoxiao, Gao Yu, Ding Tongjing, Yang Guowang, Zhang Yi, Nian Jiayun, Yu Mingwei, Wang Xiaomin

机构信息

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.

Beijing University of Chinese Medicine, Beijing, 100029, China.

出版信息

J Cancer. 2021 Mar 19;12(10):2968-2974. doi: 10.7150/jca.46600. eCollection 2021.

Abstract

We explored the clinical regularity and prognosis of lung carcinoma (LC) patients with hypercoagulability, which is often associated with the occurrence and development of tumors. This retrospective study analyzed 624 LC patients diagnosed from 2010-2017 in the Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, China. Kaplan-Meier analysis was used to estimate survival and the log-rank test was used to identify differences in survival between groups. The predictive power of a hypercoagulation model was tested using receiver operating characteristic (ROC) curve analysis. Univariate and multivariate Cox regression analyses were performed to explore independent factors associated with survival A logistic regression model was used to explore factors related to hypercoagulability. The diagnostic power of relevant influencing factors on hypercoagulability was tested using ROC curve analysis. Of 624 patients in the study, 161(25.8%) had hypercoagulability and 463 did not (normal group). The overall survival (OS) of the hypercoagulability group was significantly lower than the normal group ( < 0.0001). The ROC curve showed that the predictive power of the hypercoagulability model was better than that of a single coagulation indicator ( < 0.01). Both univariate and multivariate Cox regression analyses showed that hypercoagulability was an independent factor affecting the prognosis of LC (<0.0001). The results of the logistic regression analysis showed that clinical stage ( < 0.05), cytokeratin 19 fragment (Cyfra211) ( < 0.05), and the platelet-to-lymphocyte ratio (PLR) ( < 0.05) were positively correlated with hypercoagulability. When combining clinical stage, Cyfra211, and the PLR to predict hypercoagulability, the area under the ROC curve was 0.797 ( < 0.01). In LC, hypercoagulability is an independent factor associated with poor OS and could be a prognostic factor.

摘要

我们探讨了具有高凝性的肺癌(LC)患者的临床规律和预后,高凝性常与肿瘤的发生和发展相关。这项回顾性研究分析了2010年至2017年在中国首都医科大学附属北京中医医院诊断的624例LC患者。采用Kaplan-Meier分析来估计生存率,并使用对数秩检验来确定组间生存率的差异。使用受试者工作特征(ROC)曲线分析来测试高凝模型的预测能力。进行单因素和多因素Cox回归分析以探索与生存相关的独立因素,并使用逻辑回归模型来探索与高凝性相关的因素。使用ROC曲线分析来测试相关影响因素对高凝性的诊断能力。在该研究的624例患者中,161例(25.8%)具有高凝性,463例没有(正常组)。高凝性组的总生存期(OS)显著低于正常组(<0.0001)。ROC曲线显示,高凝模型的预测能力优于单一凝血指标(<0.01)。单因素和多因素Cox回归分析均显示,高凝性是影响LC预后的独立因素(<0.0001)。逻辑回归分析结果显示,临床分期(<0.05)、细胞角蛋白19片段(Cyfra211)(<0.05)和血小板与淋巴细胞比值(PLR)(<0.05)与高凝性呈正相关。当结合临床分期、Cyfra211和PLR来预测高凝性时,ROC曲线下面积为0.797(<0.01)。在肺癌中,高凝性是与不良总生存期相关的独立因素,并且可能是一个预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d04d/8040890/15ef2b8a2cb0/jcav12p2968g001.jpg

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