静脉血栓栓塞症患者随访期发生癌症的预测评分研究  

Cancer incidence and characteristics in patients with venous thromboembolism during follow-up

作　　者：李研[1,2] 张宇 翟振国 谢万木[2] 张竹[2] LI Yan;ZHANG Yu;ZHAI Zhenguo;XIE Wanmu;ZHANG Zhu(Beijing Hepingli Hospital,Beijing 100013,China;Department of Pulmonary and Critical Care Medicine,Center of Respiratory Medicine,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]北京市和平里医院,北京100013 [2]中日友好医院呼吸中心呼吸与危重症医学科,北京100029

出　　处：《临床肺科杂志》2023年第8期1140-1145,1155,共7页Journal of Clinical Pulmonary Medicine

摘　　要：目的 探讨我国静脉血栓栓塞症(VTE)患者在随访期癌症发生风险的相关因素,探索针对我国VTE人群的癌症风险评估模型。方法 连续入组2018年在中日友好医院住院的VTE患者,计算RIETE评分,分析发生癌症的影响因素,得出风险评分。结果 479例患者进行RIETE评分评估,其中潜在癌症高风险196例(40.9%),低风险283例(59.1%)。两组新发癌症风险无统计学差异(P=0.086)。多变量分析中诊断为少见部位VTE(OR=4.89,95%CI:1.31~18.25)、无诱因VTE(OR=4.1,95%CI:1.87~8.97)、便潜血阳性(OR=3.03,95%CI:1.35~6.81)、血小板≥350×10^(9)/L(OR=2.72,95%CI:1.10~7.33)、AFP升高(OR=4.04,95%CI:1.16~14.03)、Ca125升高(OR=3.45,95%CI:1.70~7.03)、Ca199升高(OR=4.14,95%CI:1.96~8.76)、Ca153升高(OR=5.72,95%CI:2.36~13.89)与诊断癌症的风险呈正相关。结论 1.RIETE评分对我国VTE人群在随访期发生癌症风险预测能力不佳;2.初步得到基于我国VTE人群的癌症风险预测模型,有待进一步优化及验证。Objective To explore the related factors of cancer risk in Chinese patients with venous thromboembolism(VTE)during the follow-up period,and to explore a cancer risk assessment model for VTE population in China.Methods The patients were admitted to China-Japan Friendship Hospital and diagnosed as VTE patients from January 1,2018 to December 31,2018.RIETE score was calculated to analyze the influencing factors of cancer and obtain the risk score.Results RIETE scores were used to evaluate 479 patients,including 196(40.9%)at high potential cancer risk(≥3 points)and 283(59.1%)at low risk(≤2 points).There was no significant difference in the risk of new cancer between the two groups(P=0.086).Through multivariate analysis,the patients were diagnosed as rare site VTE (4.89;95% CI : 1.31~18.25), unprovoked VTE (4.1;95% CI : 1.87~8.97), and positive fecal occultic blood (3.03;95% CI : 1.35~6.81). Platelet ≥350×10 9/ L (2.72;95% CI : 1.10~7.33), AFP elevation (4.04;95% CI : 1.16~14.03), Ca125 elevation (3.45;95% CI : 1.70~7.03), increased Ca19-9 (4.14;95% CI : 1.96~8.76), and increased Ca153 (5.72;95% CI : 2.36~13.89) were positively correlated with the risk of cancer diagnosis. Conclusion 1. The RIETE score performs poorly in predicting the risk of cancer in Chinese VTE population during the follow-up period. 2. It obtains an initial prediction model for cancer risk based on the VTE population in China, which needs to be further optimized and validated.

关 键 词：静脉血栓栓塞症 癌症 发病风险 风险评估 RIETE评分 

分 类 号：R543.6[医药卫生—心血管疾病] R730[医药卫生—内科学]