23例肺癌并发肺栓塞的临床分析

BACKGROUND AND OBJECTIVE: Malignant tumors are often complicated with pulmonary thromboembolism (PTE), particularly in lung cancer (LC). This study investigated the clinical characteristics, risk factors, and survival time of patients with PTE and LC. METHODS: We retrospectively reviewed the clinical data of patients with LC in Medical Oncology of Tianjin Medical University General Hospital between June 2009 and July 2013. A total of 23 patients suffered from both PTE and LC. A total of 46 cases were used as control subjects. The survival of these patients was compared with that of the control subjects by Kaplan-Meier analysis. RESULTS: A total of 1128 cases were diagnosed with LC, in which 23 were clearly diagnosed with PTE, and 16 (69.6%) patients who suffered from both LC and PTE developed adenocarcinoma. These patients also exhibited a higher incidence of unexplained dyspnea than those who were diagnosed with LC only (P < 0.01). The patients with both PTE and LC displayed lower counts of hemoglobin (Hb), albumin (ALB), and blood oxygen pressure (PO(2)) than those with LC only (P < 0.05). The patients with both PTE and LC also exhibited higher counts of leukocyte (WBC) and D-dimer than those with LC only (P < 0.05). No statistical difference was found between the two groups in terms of platelet counts, glutamic pyruvic transaminase level, and glutamic oxaloacetic transaminase level (P > 0.05). Ten cases (43.48%) with deep venous thrombosis were observed in the PTE and LC group, and six patients (26.09%) were at a high risk of acute pulmonary embolism. Hb < 100 g/L, WBC > 11×10(9)/L, D-Dimer > 500 ng/ml, PO(2) < 80 mmHg, ALB < 30 g/L were the risk factors of LC with PTE (odds ratio values were listed as follows: 5.50, 11.03, 4.83, 4.68, 9.63, respectively). On July 29, 2013, the median survival time of patients with PTE and LC was 7.77 months. This result was significantly lower than that (19.27 months) of patients with LC only (P=0.02). The survival time of patients suffering from both LC and PTE and undergoing chemotherapy was higher than that of patients who did not undergo such treatment. CONCLUSION: The common pathological type observed in patients with both LC and PTE was adenocarcinoma. The common clinical manifestations were unexplained dyspnea and cough. The first five months after LC diagnosis corresponded to a high period of PTE. Patients with LC and PTE exhibited less survival time. As such, chemotherapy is beneficial for the survival of patients with LC and PTE.