Silent venous thromboembolism before treatment in endometrial cancer and the risk factors.
Silent venous thromboembolism before treatment in endometrial cancer and the risk factors.
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DOI：
10.1038/sj.bjc.6604658
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发表时间：
2008-10-07
影响因子：
8.8
通讯作者：
Yoshikawa, H.
中科院分区：
文献类型：
--
作者：
Satoh, T.;Matsumoto, K.;Uno, K.;Sakurai, M.;Okada, S.;Onuki, M.;Minaguchi, T.;Tanaka, Y. O.;Homma, S.;Oki, A.;Yoshikawa, H.
静脉血栓栓塞（VTE）常发生在手术后，甚至可能发生在妇科恶性肿瘤患者的手术前。我们调查了子宫内膜癌治疗前静脉血栓栓塞的发生率和相关危险因素。检测了171例子宫内膜癌患者治疗前血浆D-二聚体（DD）水平。DD ≥ 1.5 μg ml−1的患者进行下肢静脉超声成像（VUI），因为DD对VTE的阴性预测值极高。对于深静脉血栓形成（DVT）患者，进行肺动脉造影以确定肺血栓栓塞（PTE）的存在。使用单变量和多变量分析171例患者的VTE风险因素。其中37例（21.6%）显示DD ≥ 1.5 μg ml−1，17例（9.9%）显示VUI显示DVT，8例（4.7%）显示肺动脉造影显示PTE。所有VTE患者均无症状。对各种危险因素的单变量分析显示，年龄较大、非类风湿性组织学和晚期疾病的几个变量与治疗前的VTE显著相关。肥胖、吸烟和糖尿病不是危险因素。多变量分析证实宫外播散和非类肉瘤组织学与静脉血栓栓塞风险独立且显著相关。这些数据表明，至少约10%的子宫内膜癌患者在治疗前发生无症状或亚临床VTE。治疗前VTE的风险因素可能与开始治疗后的风险因素不同。
Venous thromboembolism (VTE) often occurs after surgery and can even occur before surgery in patients with gynaecological malignancies. We investigated the incidence of VTE before treatment of endometrial cancer and associated risk factors. Plasma D-dimer (DD) levels before initial treatment were examined in 171 consecutive patients with endometrial cancer. Venous ultrasound imaging (VUI) of the lower extremities was performed in patients with DD ⩾1.5 μg ml−1, as the negative predictive value of DD for VTE is extremely high. For patients with deep vein thrombosis (DVT), pulmonary scintigraphy was performed to ascertain the presence of pulmonary thromboembolism (PTE). Risk factors for VTE were analysed using univariate and multivariate analyses for 171 patients. Of these, 37 patients (21.6%) showed DD ⩾1.5 μg ml−1, 17 (9.9%) displayed DVT by VUI and 8 (4.7%) showed PTE on pulmonary scintigraphy. All patients with VTE were asymptomatic. Univariate analysis for various risk factors revealed older age, non-endometrioid histology and several variables of advanced disease as significantly associated with VTE before treatment. Obesity, smoking and diabetes mellitus were not risk factors. Multivariate analysis confirmed extrauterine spread and non-endometrioid histology as independently and significantly associated with risk of VTE. These data suggest that silent or subclinical VTE occurs before treatment in at least around 10% of patients with endometrial cancer. Risk factors for VTE before treatment might not be identical to those after starting treatment.
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DOI：
10.1016/0002-9378(83)91205-x
发表时间：
1983-01-01
影响因子：
9.8
作者：
CLARKEPEARSON, DL;COLEMAN, RE;CREASMAN, WT
通讯作者：
CREASMAN, WT
组织因子表达是卵巢癌中血栓栓塞的可能决定因素。
影响因子：
8.8
作者：
Uno, K;Homma, S;Satoh, T;Nakanishi, K;Abe, D;Matsumoto, K;Oki, A;Tsunoda, H;Yamaguchi, I;Nagasawa, T;Yoshikawa, H;Aonuma, K
通讯作者：
Aonuma, K
影响因子：
168.9
作者：
BOUNAMEAUX, H;CIRAFICI, P;UNGER, PF
通讯作者：
UNGER, PF
影响因子：
4.7
作者：
Goff, BA;delaCuesta, RS;Fuller, AF
通讯作者：
Fuller, AF
影响因子：
9
作者：
Agnelli, G;Bolis, G;Plaino, F
通讯作者：
Plaino, F