肺癌是副肿瘤性非细菌性血栓性心内膜炎的主要病因之一：个体患者数据的荟萃分析
Lung Cancer as a Leading Cause among Paraneoplastic Non-Bacterial Thrombotic Endocarditis: A Meta-Analysis of Individual Patients' Data.
作者信息
Rahouma Mohamed, Khairallah Sherif, Dabsha Anas, Elkharbotly Ismail A M H, Baudo Massimo, Ismail Amr, Korani Omnia M, Hossny Mohamed, Dimagli Arnaldo, Girardi Leonard N, Mick Stephanie L, Gaudino Mario
机构信息
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY 10021, USA.
Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt.
出版信息
Cancers (Basel). 2023 Mar 20;15(6):1848. doi: 10.3390/cancers15061848.
Hypercoagulability is strongly associated with cancer and may result in non-bacterial thrombotic endocarditis (NBTE). The aim of our meta-analysis was to explore the demographics and characteristics of this condition in cancer. Databases were systematically searched. The outcomes were to identify the annual trend in premortem diagnosis among the entire cohort and different subgroups and to identify differences in characteristics and survival in the considered population. A total of 121 studies with 144 patients were included. The proportion of marantic endocarditis associated with lung cancer was 0.29 (95% CI, 0.21-0.37; < 0.001), that associated with pancreatic cancer was 0.19 (95% CI, 0.13-0.27; < 0.001), that associated with advanced cancer stage (metastasis) was 0.69 (95% CI, 0.61-0.76; < 0.001), and that associated with adenocarcinoma was 0.65 (95% CI, 0.56-0.72; < 0.001). Median and 6-month overall survival (OS) were 1.3 months and 32.3%, respectively, with 6-month OS of 20.8% vs. 37.0% in lung vs. other cancers, respectively ( = 0.06) and 42.9% vs. 31.1% among those who underwent intervention vs. those who did not ( = 0.07). Cases discovered in recent years had better survival (HR = 0.98 (95% CI, 0.96-0.99; = 0.003). While cancer-associated NBTE is a rare entity, lung cancers were the most common tumor site and are frequently associated with more advanced and metastatic cancer stages. The prognosis is dismal, especially among lung cancers.
高凝状态与癌症密切相关，可能导致非细菌性血栓性心内膜炎（NBTE）。我们进行荟萃分析的目的是探讨癌症患者中这种情况的人口统计学特征。我们系统检索了多个数据库。研究结果包括确定整个队列及不同亚组生前诊断的年度趋势，以及确定所研究人群在特征和生存率方面的差异。共纳入了121项研究中的144例患者。与肺癌相关的消耗性心内膜炎比例为0.29（95%CI，0.21 - 0.37；<0.001），与胰腺癌相关的为0.19（95%CI，0.13 - 0.27；<0.001），与癌症晚期（转移）相关的为0.69（95%CI，0.61 - 0.76；<0.001），与腺癌相关的为0.65（95%CI，0.56 - 0.72；<0.001）。中位总生存期和6个月总生存期（OS）分别为1.3个月和32.3%，肺癌患者的6个月总生存期为20.8%，其他癌症患者为37.0%（P = 0.06），接受干预者为42.9%，未接受干预者为31.1%（P = 0.07）。近年来发现的病例生存率更高（HR = 0.98（95%CI，0.96 - 0.99；P = 0.003）。虽然癌症相关的NBTE是一种罕见疾病，但肺癌是最常见的肿瘤部位，且常与更晚期和转移性癌症阶段相关。预后很差，尤其是肺癌患者。
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