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摘要:目的
分析恶性肿瘤合并静脉血栓栓塞症（VTE）患者的临床特点并探寻相关危险因素。
方法采用回顾性病例对照研究，调查恶性肿瘤合并VTE患者的临床及生存结局信息。采用卡方检验、Log rank检验和比例风险回归模型（Cox模型）等方法进行统计分析，采用GraphPad Prism8.0绘制生存曲线，分析VTE相关影响因素。
结果5年间共收治新发恶性肿瘤患者11 620例，其中合并VTE患者385例（3.31%）。恶性淋巴瘤患者合并VTE的比例最大，达到4.78%，其次是结直肠癌和乳腺癌，分别为4.40%和4.08%；联合治疗的患者比单一治疗方式发生VTE的比例高；分期越晚的患者合并VTE的比例越高；随访结果显示合并VTE患者中位生存时间为17.90月（95%CI: 10.21~25.59），1、3、5年生存率分别为51.89%、37.76%、18.88%；多因素分析结果显示年龄、性别、TNM分期是影响VTE患者预后的独立危险因素。
结论恶性肿瘤患者容易并发VTE，临床上应对高危患者密切观察、提早预防。
Abstract:ObjectiveTo investigate the clinical features of cancer patients with venous thromboembolism (VTE) and related risk factors.
MethodsA retrospective case-control study was conducted to investigate the clinical and survival outcomes of cancer patients with VTE. Statistical analysis of VTE-related influencing factors was performed using chi-square test, Log rank test and proportional hazard regression model (Cox model). GraphPad Prism8.0 was used to draw the survival curve.
ResultsWe collected 11 620 patients with new-onset cancer, including 385 patients with VTE. The incidence of VTE in cancer patients was 3.31%. The incidence of VTE in malignant lymphoma patients was the highest (4.78%), followed by colorectal cancer (4.40%) and breast cancer (4.08%). Patients treated with combination therapy had a higher rate of VTE. TNM staging was positively correlated with the proportion of VTE in cancer patients. The median survival time was 17.90 months (95%CI: 10.21-25.59), and the 1-, 3- and 5-year survival rates were 51.89%, 37.76% and 18.88%, respectively. Multivariate analysis results showed that age, gender and TNM staging were independent risk factors affecting the survival and prognosis of patients.
ConclusionPatients with malignant tumors are prone to VTE. High-risk patients should be closely observed to prevent VTE.
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Key words:
- Cancer /
- Venous thromboembolism /
- Risk factors /
- Prevention and treatment /
- Prognosis
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作者贡献雷海科、李小升：研究设计与实施，采集、分析数据，论文撰写龙波、李禄椿、罗敏、王璐璐、赵玉兰、周宏：研究设计，论文修改刘海霞、张维：研究的组织实施，论文审阅及修改
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