Harada Yohei, Sato Akemi, Nishioka Atsujiro, Ogusu Shinsuke, Matsumoto Masanori, Sueoka Eisaburo, Kawaguchi Atsushi, Kimura Shinya, Sueoka-Aragane Naoko
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Saga University, Saga 849-8501, Japan.
Department of Clinical Laboratory Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan.
Oncol Lett. 2023 Mar 17;25(5):180. doi: 10.3892/ol.2023.13766. eCollection 2023 May.
Prospective studies on risk factors for the occurrence of venous thromboembolism (VTE) in Asian patients with cancer are limited. Therefore, the present study assessed risk factors for VTE, including multiple blood biomarkers and risk scores consisting of several risk factors, in Japanese patients receiving anticancer drug therapy. In this single-center, prospective, observational study, 200 patients with six types of cancer were enrolled and followed for 1 year to observe the occurrence of symptomatic or asymptomatic VTE. The present study evaluated risk factors, Khorana and Vienna cancer and thrombosis study (CATS) scores at enrollment, and longitudinal data on various blood biomarkers. A Vienna CATS score of ≥3 was significantly associated with VTE occurrence (HR, 2.8; 95% CI, 0.9-8.7; P=0.045). In multivariable analysis, there was a significant association between VTE and the presence of pancreatic cancer (HR, 3.2; 95% CI, 1.1-8.8; P=0.028) and high soluble fibrin (HR, 3.7; 95% CI, 1.1-7.8; P=0.036). Covariate analysis using the propensity score also showed a significant association with hemoglobin dichotomized at <100 g/l (HR, 3.9; 95% CI, 1.1-14.0; P=0.034). Longitudinal data indicated that VTE was associated with soluble fibrin baseline values and an increase in D-dimer levels over time. The present results suggested that blood biomarkers are beneficial for predicting the risk of VTE in Japanese patients with cancer. The present study also provided novel evidence for the importance of measuring soluble fibrin in patients with cancer.
关于亚洲癌症患者发生静脉血栓栓塞（VTE）风险因素的前瞻性研究有限。因此，本研究评估了接受抗癌药物治疗的日本患者发生VTE的风险因素，包括多种血液生物标志物以及由多个风险因素组成的风险评分。在这项单中心、前瞻性、观察性研究中，纳入了200例患有六种癌症类型的患者，并随访1年以观察有症状或无症状VTE的发生情况。本研究评估了风险因素、入组时的Khorana和维也纳癌症与血栓形成研究（CATS）评分以及各种血液生物标志物的纵向数据。维也纳CATS评分≥3与VTE发生显著相关（HR，2.8；95%CI，0.9 - 8.7；P = 0.045）。在多变量分析中，VTE与胰腺癌的存在（HR，3.2；95%CI，1.1 - 8.8；P = 0.028）以及高可溶性纤维蛋白（HR，3.7；95%CI，1.1 - 7.8；P = 0.036）之间存在显著关联。使用倾向评分的协变量分析也显示与血红蛋白二分法<100 g/l存在显著关联（HR，3.9；95%CI，1.1 - 14.0；P = 0.034）。纵向数据表明，VTE与可溶性纤维蛋白基线值以及D - 二聚体水平随时间的增加有关。本研究结果表明，血液生物标志物有助于预测日本癌症患者发生VTE的风险。本研究还为在癌症患者中测量可溶性纤维蛋白的重要性提供了新的证据。
