改良Wells评分对肺癌合并静脉血栓栓塞症的诊断价值

Diagnostic value of modified Wells score in lung cancer complicated with venous thromboembolism

目的评估改良Wells评分对肺癌合并静脉血栓栓塞症(VTE)的诊断价值。方法选取住院的肺癌患者145例,评价Wells评分、血浆D-二聚体水平对肺癌合并VTE的诊断价值。结果血浆D-二聚体诊断肺癌合并VTE的最佳截断值为2.51 mg/L,Wells评分诊断肺癌合并VTE的AUC为0.703[95%CI(0.621,0.776)],Youden指数为0.407,最佳截断值为2分,其灵敏度为66.7%,特异度为74%;改良Wells评分诊断肺癌合并VTE的AUC为0.855[95%CI(0.787,0.908)],Youden指数为0.543,最佳截断值为2分,其灵敏度为93.3%,特异度为61%。改良Wells评分与Wells评分在诊断肺癌合并VTE的AUC差异有统计学意义[Z=4.712,95%CI(0.088,0.215),P<0.05]。结论改良Wells评分对肺癌合并VTE具有较高的诊断价值。

Objective To evaluate the diagnostic value of modified Wells score in lung cancer complicated with venous thromboembolism(VTE).Methods A total of 145 patients with lung cancer admitted to the hospital were selected.The diagnostic value of Wells score and plasma D dimer level in lung cancer with VTE were calculated.Results The optimal cut-off value of plasma D-dimer for the diagnosis of lung cancer with VTE was 2.51 mg/L.The AUC of Wells score for the diagnosis of lung cancer with VTE was 0.703(95%CI[0.621,0.776]),Youden index was 0.407,and the optimal cut-off value was 2 points,with the sensitivity of 66.7%and the specificity of 74%.The AUC of the modified Wells score for the diagnosis of lung cancer with VTE was 0.855(95%CI[0.787,0.908]),Youden index was 0.543 and the optimal cut-off value was 2 points,with the sensitivity of 93.3%and the specificity of 61%.The difference of AUC between the modified Wells score and the Wells score in the diagnosis of lung cancer with VTE was statistically significant(Z=4.712,95%CI[0.088,0.215],P<0.05).Conclusion The modified Wells score is of high diagnostic value for lung cancer with VTE.