在患有并发性恶性瘤的患者中诊断深静脉血栓症的最佳D-Dimer截止值
Kiyoaki Niimi1, Kazuki Nishida2, Changi Lee1
1Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Annals of vascular surgery
|July 16, 2023
概括
这项研究发现,在癌症患者中,4.0μg/mL的D-二元切割值是诊断深静脉血栓症 (DVT) 的最佳标准. 将Khorana评分与D-二次数水平相结合,与单独的Khorana评分相比,提高了DVT诊断的准确性.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 恶性瘤显著增加了静脉血栓栓塞的风险.
- 对癌症患者来说,深静脉血栓症 (DVT) 的早期诊断至关重要.
- 霍拉纳评分有助于评估化疗期间的血栓形成风险,但其诊断实用性和非化疗指示的最佳D-二次离子切断值需要进一步调查.
研究的目的:
- 为了确定在患有恶性瘤的患者中诊断DVT的最佳D-二次元切割值.
- 为了评估单独的Khorana评分的诊断性能,与结合Khorana评分和D-二次数水平的组合模型相比.
主要方法:
- 对208名患有恶性瘤的患者进行回顾性分析,这些患者接受了下肢静脉超声波.
- 使用尤登指数计算最佳的D-二次元切割值.
- 使用接收器运行特征分析对诊断模型进行比较 (仅可拉纳得分与可拉纳得分+D-二次元).
主要成果:
- 在恶性瘤中对DVT预测的最佳D-二分离子切线值被确定为3.96μg/mL,用于分析的是4.0μg/mL.
- 与Khorana评分 (1.33) 相比,4.0μg/mL的D-二次离子切除值为DVT诊断产生了更高的几率比率 (4.23).
- 合并的Khorana得分和D-二次元模型显示出明显更高的诊断准确性 (曲线下的面积:0.714) 比单独的Khorana得分 (0.611).
结论:
- 建议在患有恶性瘤的患者诊断DVT时增加4.0μg/mL的D-二聚合物水平.
- 将Khorana得分与D-二次体测量相结合,可提高该患者群体内DVT诊断的准确性.
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