Association of ALK rearrangement and risk of venous thromboembolism in patients with non-small cell lung cancer: A prospective cohort study
Association of ALK rearrangement and risk of venous thromboembolism in patients with non-small cell lung cancer: A prospective cohort study
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非小细胞肺癌患者 ALK 重排与静脉血栓栓塞风险的关联：一项前瞻性队列研究
DOI：
10.1016/j.thromres.2019.12.009
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发表时间：
2020-02-01
影响因子：
7.5
通讯作者：
Zhang, Yuhui
中科院分区：
文献类型：
--
作者：
Dou, Feifei;Zhang, Yuan;Zhang, Yuhui
背景资料：关于间变性淋巴瘤激酶（ALK）重排非小细胞肺癌（NSCLC）患者发生静脉血栓栓塞（VTE）的风险，孤立报告不一致。本研究探讨是否ALK重排可能有影响VTE在一个前瞻性coherent.Methods：在一个队列的836例连续NSCLC患者，表皮生长因子受体（EGFR）或小猫鼠肉瘤（KRAS）突变的患者被排除了VTE干扰。最终，341名合格患者接受了观察。中位随访期为7.5个月（3.1- 15.4个月）。结果：341例患者中有37例（10.9%）发生了VTE事件。在包括年龄、性别、肿瘤组织学、肿瘤分期、体能状态和ALK状态的多变量分析中，ALK重排（亚分布风险比2.47，95%置信区间1.04-5.90）与VTE风险增加相关。6个月后，有和无ALK重排的患者中VTE的累积发生率分别为26.9%和9.2%。1年后，相应的累积发生率分别为26.9%和9.7%（灰色检验P = 0.005）。结论：ALK重排的存在与非小细胞肺癌患者VTE的风险增加有关。
Background: Isolated reports are inconsistent regarding the risk of venous thromboembolism (VTE) in patients with anaplastic lymphoma kinase (ALK) rearranged non-small cell lung cancer (NSCLC). This study examined whether ALK rearrangement could have an influence on VTE in a prospective cohort.Methods: In a cohort of 836 consecutive patients with NSCLC, patients with epidermal growth factor receptor (EGFR) or kitten rat sarcoma (KRAS) mutations were ruled out for VTE interference. Finally, 341 qualified patients were observed. The median follow up period is 7.5 months (3.1-15.4m). ALK rearrangement was detected by fluorescence in situ hybridization at baseline.Results: Overall VTE events occurred in 37 (10.9%) of 341 patients. In multivariable analysis including age, sex, tumor histology, tumor stage, performance status, and ALK status, ALK rearrangement (sub-distribution hazard radio 2.47, 95% confidence interval 1.04-5.90) was associated with the increased risk of VTE. The cumulative incidence of VTE was 26.9% and 9.2% in the patients with and without ALK rearrangement after 6 months. After 1 year the corresponding cumulative incidence was 26.9% and 9.7% respectively (Gray test P = .005).Conclusions: The presence of ALK rearrangement is associated with increased risk of VTE in patients with NSCLC.