Rennebaum Shereen, Schneider Stefan W, Henzler Thomas, Desch Anna, Weiß Christel, Haubenreisser Holger, Goerdt Sergij, Morelli John N, Utikal Jochen S, Schoenberg Stefan O, Riffel Julia
Medical Faculty Mannheim, University of Heidelberg, Institute of Clinical Radiology and Nuclear Medicine, Mannheim, Germany.
University Hospital of Hamburg-Eppendorf, Clinic of Dermatology, Hamburg, Germany.
Clin Imaging. 2022 Mar;83:72-76. doi: 10.1016/j.clinimag.2021.12.012. Epub 2021 Dec 30.
Pulmonary embolism (PE) occurs frequently in patients with malignant melanoma (MM). The aim of this study is to determine the incidence of PE in patients with MM and to assess the clinical characteristics and mortality of MM patients with PE.
Medical records from 381 MM patients who underwent contrast-enhanced computed tomography were evaluated. Imaging parameters including location of PE and measurements of right heart dysfunction and clinical parameters including D-Dimer levels, local and distant tumor stage and time of death were analyzed.
PE was found in 23/381 (6%) MM patients, whereby 17/23 (74%) were detected incidentally and only 6/23 (26%) were symptomatic. The presence of PE significantly correlated with elevated D-Dimers (p < 0.001), right ventricular dysfunction (p = 0.04), higher local tumor stage (≥T3) (p = 0.05), presence of visceral (p = 0.02) or cerebral metastases (p = 0.03) and increased mortality (p = 0.05). Further, patients with central PE showed an increased mortality compared to peripheral PE (p = 0.03), but no correlation was found between the localization of PE and the occurrence of clinical symptoms (p = 0.36).
PE in patients with MM often occurs without clinical symptoms and is indicative for advanced disease and a poorer prognosis.
肺栓塞（PE）在恶性黑色素瘤（MM）患者中频繁发生。本研究旨在确定MM患者中PE的发生率，并评估MM合并PE患者的临床特征及死亡率。
对381例行增强CT检查的MM患者的病历进行评估。分析包括PE部位、右心功能不全测量值等影像学参数，以及D-二聚体水平、局部和远处肿瘤分期、死亡时间等临床参数。
在381例MM患者中发现23例（6%）发生PE，其中17例（74%）为偶然发现，仅6例（26%）有症状。PE的存在与D-二聚体升高（p<0.001）、右心室功能不全（p=0.04）、较高的局部肿瘤分期（≥T3）（p=0.05）、内脏转移（p=0.02）或脑转移（p=0.03）以及死亡率增加（p=0.05）显著相关。此外，与外周PE相比，中心性PE患者的死亡率更高（p=0.03），但未发现PE的部位与临床症状的发生之间存在相关性（p=0.36）。
MM患者的PE常无临床症状，提示疾病进展及预后较差。
