Treatment and prognostic analysis of advanced non-small cell lung cancer with venous thromboembolism
Objective To explore the levels of D-dimer in the blood of patients with advanced non-small cell lung cancer(NSCLC)complicated with venous thromboembolism(VTE)and the impact of different treatment methods on patient survival prognosis.Methods A retrospective analysis was conducted on 415 advanced NSCLC patients with complete da-ta admitted to Shanghai Pulmonary Hospital from October 1,2017 to December 31,2020.The patients were divided into two groups based on whether they had VTE(n=68)or not(n=347).The inter group comparison was conducted by u-sing a t-test.Kaplan Meier method,log rank test,and Cox risk regression model were used to analyze the overall survival status of patients and the relationship between indicators such as hemorheology and D-dimer and prognosis.Results In advanced NSCLC,the incidence of VTE was higher in adenocarcinoma patients.The erythrocyte sedimentation rate,e-rythrocyte aggregation index,fibrinogen level,and D-dimer level in patients with combined VTE were(67.00±18.00)mm/h,3.48±0.60,(5.36±0.63)g/L,and(6 357.00±1 128.00)ug/L,respectively,which were higher than those in patients without combined VTE.The t-values were 6.589,3.875,2.962 and 17.583,and the P-values were＜0.001,0.019,0.035 and＜0.001,respectively.After 30 days of anticoagulant therapy,the average levels of erythrocyte sedi-mentation rate[(42.00±10.00)mm/h],fibrinogen[(4.16±0.45)g/L],and D-dimer[(3 168.00±952.00)pg/L]de-creased in patients with VTE.Compared with before anticoagulant therapy,the differences were statistically significant,with t-values of 5.437,3.461,and 9.325,and P-values of 0.008,0.023,and＜0.001,respectively.The overall survival time of patients in the VTE combined group was 15.7 months,lower than the 20.3 months in the non VTE combined group,P=0.005.Among patients in the VTE combined group,those who received targeted therapy had the longest me-dian survival time,at 20.6 months,while those who received chemotherapy had the shortest survival time,at 15.3 months,P=0.038.Multivariate analysis showed that D-dimer levels and whether they received targeted therapy were in-dependent factors affecting the survival prognosis of patients with advanced NSCLC combined with VTE.Conclusions When the hemo rheological indicators and D-dimer levels are abnormally elevated in patients with advanced NSCLC,high vigilance should be exercised regarding the possibility of VTE.The level of D-dimer and whether targeted therapy is re-ceived affect the survival of patients with advanced NSCLC and VTE,and can guide the diagnosis and treatment of lung cancer patients with VTE.
D-dimervenous thromboembolismtargeted therapynon-small cell lung cancer
NETL
NSTL
万方数据
