卵巢癌患者并发静脉血栓形成的危险因素及预后研究

Analysis of the high risk factors and prognosis of ovarian cancer patients with venous thromboembolic complications

目的探讨卵巢癌患者发生静脉血栓形成（VTE）的高危因素,以及合并VTE对生存时间的影响。方法收集郑州大学第二附属医院自2010年7月至2014年7月共25例卵巢癌发生VTE患者的临床资料,并选取同期未发生血栓事件的卵巢癌患者50例作为对照组,对两组患者的临床参数,包括年龄、体重指数（BMI）、高血压、糖尿病、高脂血症、CA125水平、国际妇产科联盟（FIGO）分期和分级、组织学类型、化疗和生存数据进行分析和比较。结果在对血栓组和非血栓组的单因素分析中,CA125水平（Z=-1.978,P=0.048）、晚期癌（χ2=4.653,P=0.031）、透明细胞癌（χ2=8.248,P=0.049）和高脂血症（χ2=4.807,P=0.028）是发生VTE的潜在危险因素。在多因素分析中,晚期癌和高脂血症为VTE的独立危险因素,OR值分别为10.836（95%CI 1.807～108.025,P=0.042）、4.421（95%CI 1.173～16.658,P=0.028）。血栓组25例中,没有出现因VTE直接导致死亡的事件,但血栓组的中位生存时间为41.0（4～43）个月,非血栓组的中位生存时间为55.0（1～60）个月,两组的生存时间差异有统计学意义（P=0.004）。结论卵巢癌患者发生VTE的风险高,应及时进行危险因素评估并对高危患者在围手术期和化疗期间积极采取预防性措施,以减少VTE的发生。

Objective To identify the incidence and risk factors,and the impact of venous thromboembolism（VTE）on survival of patients with ovarian cancer.Methods We collected the clinical information of 25 cases of ovarian cancer with VTE in the Second Affiliated Hospital of Zhengzhou University from July 2010 to July 2014,and randomly selected50 cases of ovarian cancer patients without VTE with the same histological types as control group.We analyzed and compared the clinical parameters of two groups,including ages,BMI,hypertensive disease,diabetes,hyperlipemia,the level of CA125,FIGO staging and grading,histological type,chemotherapy and survival data.Results Univariate analysis of potential risk factors in patients with VTE and without VTE showed that the level of CA125（Z=-1.978,P=0.048）,more advanced stage（Ⅲ＋Ⅳ）（χ2=4.653,P=0.031）,clear cell carcinoma（χ2=8.248,P=0.049）and hyperlipemia（χ2=4.807,P=0.028）were the potential risk factors of developing VTE.In multivariate analysis,the advanced stage（OR=10.836,[95%CI：1.087-108.025],P=0.042）and hyperlipemia（OR=4.421,[95%CI：1.173-16.658,P=0.028]）were the independent risk factors of VTE.In the 25 cases of patients with VTE,none of them had a fatal VTE event,but the mean survival time was shorter than the patients without VTE（41.0 months vs.55.0 months,P=0.0370.05）.Conclusion There is a high risk of VTE in patients with ovarian cancer.It should be done to evaluate the risk factors and take some preventive measures during perioperation and chemotherapy to reduce the occurrence of VTE.