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免疫检查点抑制剂治疗晚期肺癌并发深静脉血栓的危险因素分析
Risk factors for deep venous thrombosis in patients with advanced lung cancer after treatment of immune checkpoint inhibitors
- 陆军军医大学学报 2022年44卷第22期 页码：2317-2323
- 作者机构：
1.400030 重庆, 重庆大学附属肿瘤医院肿瘤内科
2.400030 重庆, 重庆大学附属肿瘤医院健康体检与肿瘤筛查中心
- 作者简介：
[刘余冰雪，E-mail: 331251902@qq.com LIU Yubingxue, E-mail: 331251902@qq.com
- 基金信息：重庆市重点疾病防治技术攻关课题(2019ZX002)
DOI：10.16016/j.2097-0927.202205168
中图分类号： R364.15;R734.2;R979.19收稿：2022-05-30，
修回：2022-06-27，
纸质出版：2022-11-30
- 稿件说明：
移动端阅览
陈文, 刘余冰雪, 曾祥华, 等. 免疫检查点抑制剂治疗晚期肺癌并发深静脉血栓的危险因素分析[J]. 陆军军医大学学报, 2022,44(22):2317-2323.
Wen CHEN, Yubingxue LIU, Xianghua ZENG, et al. Risk factors for deep venous thrombosis in patients with advanced lung cancer after treatment of immune checkpoint inhibitors[J]. Journal of Army Medical University, 2022, 44(22): 2317-2323.
陈文, 刘余冰雪, 曾祥华, 等. 免疫检查点抑制剂治疗晚期肺癌并发深静脉血栓的危险因素分析[J]. 陆军军医大学学报, 2022,44(22):2317-2323. DOI： 10.16016/j.2097-0927.202205168.
Wen CHEN, Yubingxue LIU, Xianghua ZENG, et al. Risk factors for deep venous thrombosis in patients with advanced lung cancer after treatment of immune checkpoint inhibitors[J]. Journal of Army Medical University, 2022, 44(22): 2317-2323. DOI： 10.16016/j.2097-0927.202205168.
摘要
目的
2
分析晚期肺癌患者经免疫检查点抑制剂(immune checkpoint inhibitors，ICIs)治疗后发生静脉血栓事件(venous thromboembolism event，VTE)的危险因素。
方法
2
收集2018年6月至2021年10月在重庆大学附属肿瘤医院肿瘤内科接受ICIs治疗的晚期肺癌患者320例。根据彩超或电子计算机断层扫描诊断是否有深静脉血栓(deep vein thrombosis，DVT)或肺动脉栓塞(pulmonary embolism，PE)将患者分为VTE组(
n
=31)和非VTE组(
n
=289)，比较两组临床资料的差异，采用二元Logistic回归分析VTE的独立危险因素。
结果
2
320例患者中有31例发生VTE，VTE发生率为9.69%。单因素分析发现VTE组和非VTE组的年龄、糖尿病、Caprini评分≥5分占比、D-二聚体≥0.5 mg/L占比、IL-8水平、IL-6水平、TNF-α水平差异均具有统计学意义(
P
<
0.05)。二元Logistic回归分析发现VTE的独立危险因素为: Caprini评分≥5分(
OR
=4.236，95%
CI
: 1.754~10.231，
P
=0.001)、糖尿病(
OR
=2.801，95%
CI
: 1.008~7.784，
P
=0.048)、TNF-α
>
12.8 pg/mL(
OR
=14.178，95%
CI
: 5.588~35.973，
P
<
0.001)。
结论
2
Caprini评分≥5分、糖尿病、TNF-α >12.8 pg/mL是晚期肺癌患者经ICIs治疗后发生VTE的独立危险因素。
Abstract
Objective
2
To analyze the risk factors for venous thromboembolism event (VTE) in patients with advanced lung cancer treated with immune checkpoint inhibitors (ICIs).
Methods
2
A total of 320 patients with advanced lung cancer treated with ICIs at the department of medical oncology of Chongqing University Cancer Hospital from June 2018 to October 2021 were collected and retrospectively reviewed. Deep vein thrombosis (DVT) or pulmonary embolism (PE) diagnosed by ultrasound or computed tomography from the first dose of ICIs treatment to the end of observation time. The patients were divided into VTE group (
n
=31) and non-VTE group (
n
=289)
the clinical data of the two groups were compared
and independent risk factors for VTE were analyzed by binary logistic regression.
Results
2
The incidence of VTE was 9.69%. Univariate analysis showed that there were statistically significant differences in age
proportions of patients with diabetes mellitus
Caprini score (≥5)
D-dimer(≥0.5 mg/L) and the levels of IL-8
IL-6 and TNF-α between the VTE group and the non-VTE group (
P
<
0.05). Binary logistic regression analysis revealed that the Caprini score ≥5 (
OR
=4.236
95%
CI
: 1.754~10.231
P
=0.001)
diabetes mellitus (
OR
=2.801
95%
CI
: 1.008~7.784
P
=0.048)
and TNF-α
>
12.8 pg/mL (
OR
=14.178
95%
CI
: 5.588~35.973
P
<
0.001) were the independent risk factors for VTE.
Conclusion
2
Caprini score (≥5)
diabetes mellitus and TNF-α (> 12.8 pg/mL) are the independent risk factors for VTE in patients with advanced lung cancer after the treatment of ICIs.
关键词
Keywords
references
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