食管癌患者静脉血栓栓塞情况及相关因素分析

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Abstract Objective To investigate the incidence and risk factors of venous thromboembolism in hospitalized patients with esophageal cancer. Methods Clinical data of 466 patients with esophageal cancer treated in the Third Medical Center of PLA General Hospital from January 2020 to January 2023 were retrospectively analyzed, including general data (age, sex, body mass index, past history) and laboratory parameters (D-dimer, fibrinogen, albumin, serum homocysteine, and platelet). Venous color Doppler ultrasound was performed for all patients after admission, and CT pulmonary angiography was performed for patients with pulmonary symptoms to screen the incidence of venous thromboembolism. According to the occurrence of venous thromboembolism, they were divided into venous thromboembolism group (VTE group) and control group. Logistic multivariate regression analysis was used to summarize the related factors affecting the occurrence of venous thromboembolism and then the intervention strategies were discussed. Results Among 466 cases, venous thromboembolism occurred in 43 cases (9.2%). There were 6 cases (13.9%) of venous thrombosis in upper extremity.There were 35 cases (81.4%) of venous thrombosis in lower extremity and 2 cases (4.7%) of pulmonary venous thrombosis. Univariate analysis showed that the levels of age, serum D-dimer, fibrinogen, serum homocysteine (HCY) and platelet in the venous thromboembolism group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). Multivariate unconditional Logistic regression analysis showed that age, serum D-dimer level, fibrinogen and HCY were the risk factors for venous thrombosis (P<0.05). Conclusions The incidence of venous thromboembolism in hospitalized patients with esophageal cancer is high, most of the patients are asymptomatic and lower limb venous thrombosis is common. Age, serum D-dimer level, fibrinogen, and serum HCY are independent risk factors for venous thromboembolism in patients with esophageal cancer.

Key words： esophageal cancer venous thromboembolism serum homocysteine fibrinogen D-dimer level

Received: 20 May 2023

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	LI Hua
	LIANG Yan
	BIAN Chenfeng

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LI Hua,LIANG Yan,BIAN Chenfeng. Analysis of venous thromboembolism and related factors in inpatients with esophageal cancer[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2023, 34(12): 1038-1041.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2023/V34/I12/1038

[1]	Chew H K, Wun T, Harvey D, et al. Incidence of venous thromboembolism and its effect on survival among patients with common cancers [J]. Arch Intern Med, 2006, 166(4):458-464
[2]	Khorana A A, Francis C W, Culakova E, et al. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy [J]. J Thromb Haemost, 2007, 5(3):632-634.
[3]	刘宗超,李哲轩,张阳,等.2020全球癌症统计报告解读[J].肿瘤综合治疗电子杂志,2021,7(2):1-14.
[4]	Hanna N M,Williams E, Kong W, et al. Incidence, timing, and outcomes of venous thromboembolism in patients undergoing surgery for esophagogastric cancer: a population-based cohort study[J]. Ann Surg Oncol, 2022,9:4393-4404.
[5]	李晓强,张福先,王深明.深静脉血栓形成的诊断和治疗指南(第三版)[J].中国血管外科杂志(电子版),2017,9(4): 250-257.
[6]	Konstantinides S V, Meyer G, Becattini C, et al. 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the european respiratory society: the task force for the diagnosis and management of acute pulmonary embolism of the european society of cardiology (ESC)[J]. Eur Respir J, 2019, 54 (3):1-68.
[7]	Clagett G P, Reisch J S. Prevention of venous thromboembolism in general surgical patients. Results of metaanalysis[J]. Ann Surg, 1988,208:227-240.
[8]	Hata T, Ikeda M, Miyata H, et al. Frequency and risk factors for venous thromboembolism after gastroenterological surgery based on the Japanese National Clinical Database [J]. Ann Gastroent Surg, 2019, 3(5):534-543.
[9]	孙晓芳,高岚,李晓芳,等.不同年龄段消化系统恶性肿瘤合并静脉血栓栓塞症患者临床特征分析[J].中华实用诊断与治疗杂志,2022,36(1):76-79.
[10]	Yang F, Qi X, Gao Z, et al. Homocysteine injures vascular endothelial cells by inhibiting mitochondrial activity [J]. Exp Ther Med, 2016, 12(4): 2247-2252.
[11]	Romecín P, Atucha N M,Navarro E G, et al. Role of homocysteine and folic acid on the altered calcium homeostasis of platelets from rats with biliary cirrhosis [J]. Platelets,2017,28(7) :698-705.
[12]	Malinowska J,Olas B.Homocysteine and its thiolactone -mediated modification of fibrinogen affect blood platelet adhesion [J]. Platelets,2012,23( 5) : 409-412.
[13]	Arques S. Human serum albumin in cardiovascular diseases [J]. Eur J Intern Med, 2018, 52: 8-12.
[14]	Kahr H S, Christiansen O B, Hogdall C, et al. Endometrial cancer does not increase the 30-day risk of venous thromboembolism following hysterectomy compared to benign disease. a danish national cohort study [J]. J Gynecol Oncol, 2019,155(1):112-118.
[15]	Alyssa M C, Malachy J S,Scott E F, et al. Relation of venous thromboembolism risk to ischemic stroke risk in hospitalized patients with cancer [J].Am J Cardiol,2019,123(4):679-683.
[16]	Theochari A N,Theochari A C,Kokkinidis G D, et al. Venous thromboembolism after esophagectomy for cancer: a systematic review of the literature to evaluate incidence, risk factors, and prophylaxis[J]. Surg Today, 2021,52 (2):171-181.
[17]	Wang D,Yu Y,Tao P, et al. Risk of venous thromboembolism in patients undergoing gastric cancer surgery: protocol for a systematic review and meta-analysis[J]. BMJ Open, 2020,10(1):1-5.
[18]	刘晓阳,尹星华,戴丽,等.人工膝关节置换术后下肢深静脉血栓患者的临床特征和高危因素[J].武警医学,2022,33(3):222 - 225.
[19]	Lobastov K,Urbanek T,Stepanov E, et al. The thresholds of caprini score associated with increased risk of venous thromboembolism across different specialties: a systematic review [J]. Ann Surg, 2023, 277(6):929-937.
[20]	Hyerim H,Hee Y K, Kwangsoo K, et al. Application of the khorana score for cancer-associated thrombosis prediction in patients of east asian ethnicity undergoing ambulatory chemotherapy[J]. Thromb J, 2023, 21(1):1-8.