抗肿瘤治疗的肺腺癌患者发生静脉血栓栓塞的情况及危险因素分析

Incidence and Risk Factors of Venous Thromboembolism in Patients with Lung Adenocarcinoma Receiving Anti-tumor Therapy

背景与目的静脉血栓栓塞(venous thromboembolism,VTE)是癌症患者最常见的并发症,也是癌症患者死亡的第二大原因。肺腺癌患者发生VTE的管理重点在于早期、及时发现危险因素。本研究旨在调查抗肿瘤治疗的肺腺癌患者VTE发生现状,探讨在抗肿瘤治疗过程中发生VTE的影响因素,为VTE的早期识别和筛查提供依据。方法收集2019年12月-2021年5月于南京医科大学第一附属医院确诊为肺腺癌且行抗肿瘤治疗患者的临床资料,分别采用Cox单因素及多因素回归分析、Kaplan-Meier曲线和Log-rank检验比较独立危险因素影响VTE发生的差异。结果Cox回归单因素及多因素分析显示,VTE病史、靶向药物治疗、放疗是抗肿瘤治疗肺腺癌患者VTE发生的危险因素(P<0.05)。Kaplan-Meier曲线和Log-rank检验比较独立危险因素发现VTE病史、靶向治疗、放疗患者的VTE发生率更高(P<0.05)。结论有VTE病史、放疗、靶向治疗是VTE发生的高危因素,对于这类影响因素的早期识别和筛查有助于今后临床实践中VTE的防控和管理。

Background and objective Venous thromboembolism(VTE)as the most common cancer-associated complication has become the second death-causing reason among cancer patients.The management of VTE in patients with lung adenocarcinoma should focus on early and timely detection of risk factors.The aim of the study is to investigate the current situation of VTE in patients with lung adenocarcinoma treated with anti-tumor therapy and then explore the risk factors associated with the occurrence of VTE during anti-tumor therapy for early detection and screening of VTE.Methods The present study included patients diagnosed as lung adenocarcinoma undergoing anti-tumor therapy in First Affiliated Hospital of Nanjing Medical University between December 2019 and May 2021.The risk factors were identified via univariate and multivariate Cox analysis.The incidence of independent risk factors were investigated through Kaplan-Meier curves combined with Log-rank test.Results The results of univariate and multivariate Cox regression showed that history of VTE,targeted therapy and radiotherapy were risk factors for VTE in patients with lung adenocarcinoma treated with anti-tumor therapy(P<0.05).Furthermore,the results of Kaplan-Meier curves and Log-rank tests indicated the incidences of VTE in patients with history of VTE,targeted therapy and radiotherapy were higher(P<0.05).Conclusion History of VTE,radiotherapy and targeted therapy are found as independent risk factors for the occurrence of VTE,which should be identified and monitored for reduction of VTE incidence.