与癌症相关的脊柱静脉血栓形成的自然史
Hanqing Shang1, Jun Y Jiang2, Danielle Guffey3
1Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Journal of thrombosis and haemostasis : JTH
|February 3, 2024
概括
癌症相关的静脉血栓症 (SpVT) 是一种复杂的疾病. 在平淡的SpVT中,抗凝血 (AC) 需要仔细评估风险,因为结果和出血风险各不相同.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 血管医学 血管医学
背景情况:
- 与癌症相关的脊柱静脉血栓症 (SpVT) 管理存在挑战.
- 了解SpVT的自然史和治疗模式至关重要.
研究的目的:
- 根据癌症类型和血栓构成来描述SpVT的自然史.
- 评估 SpVT 患者的抗凝血 (AC) 实践和结果.
- 评估静脉血栓栓塞 (VTE),出血,再通道化和死亡率的发生率.
主要方法:
- 在两个癌症中心进行了回顾性队列研究.
- 对15342名癌症患者的分析,确定了298名孤立的SpVT.
- 对VTE和出血6个月发病率的竞争风险方法;死亡率的考克斯回归.
主要成果:
- 与SpVT一起的肝细胞癌 (HCC) 显示了较低的AC率 (2%),但与对照组相比,与VTE风险相似.
- 瘤血栓,与平淡的血栓不同,与较差的生存率相关.
- 非HCC bland SpVT中的抗凝血与增加的回通道化有关,但没有改善VTE,出血或死亡率.
结论:
- 与癌症相关的SpVT是异质的,与通常地点VTE相比,具有不同的管理.
- 瘤血栓的存在是一个显著的负面预后指标.
- 对于平淡的SpVT,抗凝药需要平衡地考虑血栓形成和出血风险.
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