肺癌合并肺栓塞危险因素及预后的临床分析

BACKGROUND AND OBJECTIVE: Malignant tumors often combined with venous thrombosis and pulmonary embolism, especially in lung cancer. It has been proven that, the mechanisms and risk factors for lung cancer patients contracting pulmonary embolism are unclear. The aim of this study is to summarize the clinical data on 54 patients with lung cancer and concomitant pulmonary embolism, and to analyze the risk factors and prognosis of lung cancer with pulmonary thromboembolism (PTE). METHODS: From April 1999 to January 2010, the clinical presentation of lung cancer patients with PTE from the Jiangsu Cancer Hospital and the Jiangsu Gerontic Institute were evaluated in the present retrospective study. Univariate analysis was conducted to determine the possible associated variables. Conditional logistic regression analysis was applied to explore risk factors of pulmonary embolism. Patient survival was also compared with matched controls via a Log-rank test. RESULTS: A total of 54 lung cancer patients with PTE, matched with 162 lung cancer patients as controls, were included. In the univariate analysis, a P < 0.20 was considered as possible risk factor, which was included into the logistic regression model. The logistic regression model showed that the OR combined with pulmonary embolism was 2.64 in patients receiving chemotherapy, 2.25 in patients with stage Ⅲ-Ⅳ disease, 2.39 in patients combined with chronic obstructive pulmonary disease (COPD), 2.12 in patients with adenocarcinoma, 2.10 in patients with serum hemoglobin>140 g/L, and 1.76 in patients with central venous catheters. A significant difference was observed among the groups that received chemotherapy, adenocarcinoma, stage Ⅲ-Ⅳ disease and high henoglobin (P < 0.05). The survival time in patients with pulmonary embolism was remarkably lower than that in patients without pulmonary embolism (P=0.02). CONCLUSION: Chemotherapy, late stage disease and high serum hemoglobin are important risk factors for lung cancer patients with concomitant pulmonary embolism. The survival time of these patients is significantly lower than that in patients without pulmonary embolism.