Clinicopathological features and prognostic factors of patients with lung cancer complicated with pulmonary infarction
Objective To investigate the clinicopathological features and prognosis of patients with lung cancer complicated with pulmonary infarction.Methods A descriptive case series study was conducted.The clinical data of 105 patients with lung cancer complicated with pulmonary infarction who underwent treatment in Shandong University Cancer Center be-tween 1 July 2014 and 1 July 2021 were analyzed retrospectively.The survival status of the patients was followed up via telephone,text messages,and emails.The survival rate was calculated using the Kaplan-Meier method,and the log-rank test was used to compare the survival curves between groups.A multivariate Cox proportional hazards model was used in to explore the prognostic factors.Results Of the 105 lung cancer patients with pulmonary embolism,76 were male(72.38％)and 29 were female(27.62％),with an age range of 37 to 76 years(median age 59 years).The median overall survival of the whole cohort was 12.0(95％CI:6.5-17.5)months.Univariate analysis revealed that age,smoking history,D-dimer elevation,Eastern Cooperative Oncology Group(ECOG)score,pathological type,TNM stage,the number of lung lobes involved were risk factors for the prognosis of patients with lung cancer complicated with pulmonary infarction(all P＜0.05).The results of multivariate analysis showed that smoking history(HR=1.909,95％CI:1.128-3.229,P=0.016),elevated level of D-2 polymer(HR=4.853,95％CI:2.557-9.213,P＜0.001),small cell carcinoma(HR=2.631,95％CI:1.546-4.479,P＜0.001)and the number of lung lobes involved(HR=2.522,95％CI:1.282-4.962,P=0.007)were factors influencing patient prognosis.Conclusions The clinical onset of lung cancer with pulmonary infarction is relatively rare.Central lung cancer,small cell carcinoma,tumor stage T3-4 or N2-3,etc.,are important clinical pathological characteristics.Patients with a smoking history,increased D-dimer,small cell carcinoma,and involvement of multiple lobes may have a poorer prognosis.
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