Shen V S, Pollak E W
South Med J. 1980 Jul;73(7):841-3. doi: 10.1097/00007611-198007000-00005.
The incidence of fatal and nonfatal pulmonary embolism (PE) was evaluated in a series of 578 patients, to quantify the suspected higher risk in cancer patients of death from massive PE when compared with patients not having cancer. PE occurred in 13% and was fatal in 8% of noncancer patients. It occurred in 17% and was fatal in 14% (P less than .05) of cancer patients. Of these cases of PE, 75% occurred in patients with adenocarcinoma and 62% in those having tumors of the pancreas, breast, large bowel, prostate, lung, and ovary. One of every seven hospitalized cancer patients died not of cancer but of PE, and 60% of all patients who died of massive PE had localized cancer or limited metastatic disease which would have allowed for reasonably long survival in absence of lethal PE. Accordingly, we strongly suggest use of prophylactic anticoagulation in hospitalized cancer patients having otherwise good prospects for reasonably long survival.
对578例患者进行了评估，以量化癌症患者与非癌症患者相比，因大面积肺栓塞（PE）死亡的疑似更高风险。非癌症患者中PE的发生率为13%，死亡率为8%。癌症患者中PE的发生率为17%，死亡率为14%（P<0.05）。在这些PE病例中，75%发生在腺癌患者中，62%发生在胰腺、乳腺、大肠、前列腺、肺和卵巢肿瘤患者中。每七名住院癌症患者中就有一名不是死于癌症，而是死于PE，所有死于大面积PE的患者中有60%患有局限性癌症或有限的转移性疾病，若无致命性PE，这些患者本可存活相当长的时间。因此，我们强烈建议对有合理长期生存良好前景的住院癌症患者使用预防性抗凝治疗。
