Deep venous thrombosis and occult malignancy: an epidemiological study
Deep venous thrombosis and occult malignancy: an epidemiological study
复制标题
深静脉血栓形成与隐匿性恶性肿瘤：流行病学研究
作者：
M. Nordstrom;B. Lindblad;H. Anderson;D. Bergqvist;T. Kjellstrom
摘要目的：探讨经静脉造影证实的下肢深静脉血栓形成患者发生癌症的风险。设计：随访1984- 1988年间因怀疑深静脉血栓而进行静脉造影的所有患者。患者通过癌症登记处追踪至1991年1月1日。对象：某医院4399例静脉造影患者。背景-瑞典马尔莫的一家综合医院，为23万人口提供服务。主要结果测量：记录的癌症数量。结果如下：4399例患者因疑似深静脉血栓形成接受静脉造影; 604例在静脉造影时已知患有恶性肿瘤，并从进一步分析中排除。1383人患有深静脉血栓，其中150人随后患上癌症。在2412名没有血栓形成的患者中，有182人患上了癌症。在造影后的前6个月内，有血栓形成的66例患者发生恶性肿瘤，而无血栓形成的37例患者发生恶性肿瘤（P<0.0001）。深静脉血栓组中38例癌症通过病史、体格检查和实验室检查发现。三名患者出现术后或创伤后深静脉血栓。在其余的病人中，只有两名可以通过广泛的筛查及早发现。六个月后，有和无血栓形成的患者的癌症发病率相同。结论：深静脉血栓形成与诊断后前六个月内恶性肿瘤的发生率显着较高相关。恶性肿瘤可以通过简单的临床和诊断方法发现，不需要广泛的筛查。
Abstract Objective: To determine the risk of subsequent cancer in patients with deep venous thrombosis confirmed by venography. Design: Follow up of all patients who had venography for suspected deep venous thrombosis during 1984-88. Patients were traced through a cancer registry up to 1 January 1991. Subjects: 4399 patients who had phlebography in one hospital. Setting - General hospital in Malmo, Sweden, serving a population of 230 000. Main outcome measure: Number of cancers recorded. Results: 4399 patients had venography for suspected deep venous thrombosis; 604 were known to have a malignancy at the time of venography and were excluded from further analysis. 1383 had deep venous thrombosis, 150 of whom subsequently developed cancer. 182 of the 2412 patients without thrombosis developed cancer. During the first six months after venography 66 patients with thrombosis developed malignancy compared with 37 patients without thrombosis (P<0.0001). 38 of the cancers in the deep venous thrombosis group were detected by history, physical examination, and laboratory tests. Three patients had postoperative or post-traumatic deep venous thromboses. Only two of the remaining patients would have benefited from early detection by extensive screening. After six months the incidence of cancer was identical in patients with and without thrombosis. Conclusion: Deep venous thrombosis is associated with a significantly higher frequency of malignancy during the first six months after diagnosis. Malignancies can be found with simple clinical and diagnostic methods and extensive screening is not required.