Xiong Wei, Zhao Yunfeng, Du He, Wang Yanmin, Xu Mei, Guo Xuejun
Department of Pulmonary and Critical Care Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine,Shanghai, No. 1665, Kongjiang Road, Yangpu District, Shanghai, 200092, China.
Department of Pulmonary and Critical Care Medicine, Punan Hospital, Pudong New District, Shanghai, China.
Thromb J. 2021 Dec 4;19(1):95. doi: 10.1186/s12959-021-00339-x.
Cancer-associated venous thromboembolism (VTE) is common in patients with primary lung cancer. It has been understudied which authoritative risk assessment score of cancer-associated VTE is optimal for the assessment of VTE development in hospitalized medical patients with lung cancer.
Patients with lung cancer who had undergone computed tomography pulmonary angiography (CTPA), compression ultrasonography (CUS) of lower and upper extremities, and/or planar ventilation/perfusion (V/Q) scan to confirm the presence or absence of VTE during a medical hospitalization were retrospectively reviewed. Based on the actual prevalence of VTE among all patients, the possibility of VTE were reassessed with the Khorana score, the PROTECHT score, the CONKO score, the ONKOTEV score, the COMPASS-CAT score, and the CATS/MICA score, to compare their assessment accuracy for VTE development.
A total of 1263 patients with lung cancer were incorporated into the final analysis. With respect to assessment efficiency for VTE occurrence, the scores with adjusted agreement from highest to lowest were the ONKOTEV score (78.6%), the PROTECHT score (73.4%), the CONKO score (72.1%), the COMPASS-CAT score (71.7%), the Khorana score (70.9%), and the CATS/MICA score (60.3%). The ONKOTEV score had the highest Youden index which was 0.68, followed by the PROTECHT score (0.58), the COMPASS-CAT score (0.56), the CONKO score (0.55), the Khorana score (0.53), and the CATS/MICA score (0.23).
Among the Khorana score, the PROTECHT score, the CONKO score, the ONKOTEV score, the COMPASS-CAT score, and the CATS/MICA score which are approved by authoritative guidelines, the ONKOTEV score is optimal for the assessment of VTE development in hospitalized medical patients with lung cancer.
癌症相关静脉血栓栓塞症（VTE）在原发性肺癌患者中很常见。对于评估住院肺癌患者发生VTE的情况，哪种权威的癌症相关VTE风险评估评分最为合适，目前研究较少。
回顾性分析在住院期间接受计算机断层扫描肺动脉造影（CTPA）、上下肢压迫超声检查（CUS）和/或平面通气/灌注（V/Q）扫描以确认是否存在VTE的肺癌患者。根据所有患者中VTE的实际患病率，使用Khorana评分、PROTECHT评分、CONKO评分、ONKOTEV评分、COMPASS-CAT评分和CATS/MICA评分重新评估VTE发生的可能性，以比较它们对VTE发生的评估准确性。
共有1263例肺癌患者纳入最终分析。关于VTE发生的评估效率，调整一致性从高到低的评分依次为ONKOTEV评分（78.6%）、PROTECHT评分（73.4%）、CONKO评分（72.1%）、COMPASS-CAT评分（71.7%）、Khorana评分（70.9%）和CATS/MICA评分（60.3%）。ONKOTEV评分的约登指数最高，为0.68，其次是PROTECHT评分（0.58）、COMPASS-CAT评分（0.56）、CONKO评分（0.55）、Khorana评分（0.53）和CATS/MICA评分（0.23）。
在权威指南认可的Khorana评分、PROTECHT评分、CONKO评分、ONKOTEV评分、COMPASS-CAT评分和CATS/MICA评分中，ONKOTEV评分最适合评估住院肺癌患者发生VTE的情况。
