Cancer-associated thrombosis: clinical presentation and survival.
Cancer-associated thrombosis: clinical presentation and survival.
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DOI：
10.2147/cmar.s47094
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发表时间：
2013-01-01
影响因子：
3.3
通讯作者：
Amer, Magid H
中科院分区：
文献类型：
--
作者：
Amer, Magid H
背景：血栓栓塞事件是癌症患者发病率和死亡率的重要原因。在以社区为基础的环境中的临床表现尚未完全澄清。本研究的目的是评估癌症患者血栓形成后的发病率、危险因素、血栓形成倾向的作用和随后的生存率。方法：对作者在一个地区癌症中心观察的所有经组织学证实的癌症患者的临床资料进行回顾性分析，重点是癌症相关血栓形成。在2005年至2012年期间，在1874名癌症患者中，有307名（16.4%）在其一生中发生了血栓形成。在这些患者中，37例（2%）有血栓形成病史，而其余270例（14.4%）患者在诊断癌症前3个月或诊断癌症后的任何时间发生血栓形成，认为与癌症相关。这些患者包括230例（12.3%）静脉血栓形成，28例（1.5%）动脉闭塞，12例（0.6%）静脉和动脉血栓形成。与其他种族相比，高加索血统的患者更容易发生血栓形成，多基因血栓形成倾向的发生率更高。在回归分析中，只有晚期癌症和动脉粥样硬化的存在是血栓形成的预测。静脉血栓形成与动脉血栓形成之间无显著差异。最差的生存率是在癌症诊断前3个月或诊断后不久发生血栓形成的患者。最近有一个改善的生存结果after therapy.CONCLUSION：除了静脉血栓形成，动脉闭塞中风和心绞痛症状是比较常见的癌症患者，特别是那些高加索血统，并可能与遗传易感性。
BACKGROUND: Thromboembolic events are important causes of morbidity and mortality in cancer patients. Clinical presentation in a community-based setting has not been fully clarified. The purpose of this study was to evaluate the incidence, risk factors, role of thrombophilia, and subsequent survival following thrombosis in cancer patients.METHODS: A retrospective review was undertaken of clinical data for all consecutive patients with histologically confirmed cancer seen by the author at a regional cancer center, with emphasis on cancer-related thrombosis.RESULTS: Between 2005 and 2012, of 1874 cancer patients, 307 (16.4%) developed thrombosis during their lifetime. Of these patients, 37 (2%) had a history of thrombosis, while the remaining 270 (14.4%) patients developed thrombosis 3 months before or any time after diagnosis of cancer, which was considered to be cancer-related. These patients included 230 (12.3%) with venous thrombosis, 28 (1.5%) cases with arterial occlusion, and 12 (0.6%) with combined venous and arterial thrombosis. Patients of Caucasian ancestry were more prone to develop thrombosis, with a higher frequency of multiple genetic thrombophilia compared with other ethnic groups. In regression analysis, only advanced stages of cancer and the presence of atherosclerosis were predictive of thrombosis. There were no significant differences between venous and arterial thrombosis. The worst survival was noted in patients who developed thrombosis 3 months prior to or shortly after their diagnosis of cancer. There has been a recent improved survival outcome following therapy.CONCLUSION: In addition to venous thrombosis, arterial occlusion with stroke and anginal symptoms is relatively common among cancer patients, especially those of Caucasian ancestry, and is possibly related to genetic predisposition.