多发性骨髓瘤:非计划的诊断途径和与风险因素和存活率的关联 - - 丹麦全国性的基于登记册的队列研究
Linda Aagaard Rasmussen1, Peter Vedsted2,3, Henry Jensen4
1Research Unit for General Practice, Aarhus, Denmark. linda.rasmussen@ph.au.dk.
BMC cancer
|August 12, 2024
概括
多发性骨髓瘤往往是出乎意料地诊断出来的,特别是在具有高并发性或晚期疾病的患者中. 通过非计划途径的诊断与较差的生存结果有关,突出显示了早期检测策略的必要性.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 多发性骨髓瘤经常表现出非特异性症状,导致诊断延迟.
- 相当一部分多发性骨髓瘤病例是通过非计划的,往往是急性护理途径来诊断的.
研究的目的:
- 在非计划的诊断途径中调查多发性骨髓瘤诊断的特征.
- 探索非计划性诊断与患者因素,疾病概况和生存结果之间的关联.
主要方法:
- 丹麦从2014年到2018年进行了一项基于登记的全国性研究.
- 被诊断为多发性骨髓瘤的患者根据他们的诊断是否通过计划外的途径 (急性入院前30天内) 发生而被分类.
- 与所有其他诊断途径进行了比较.
主要成果:
- 在2,213名多发性骨髓瘤患者中,32%的患者通过未计划的途径被诊断出患有多发性骨髓瘤.
- 与非计划性诊断相关的因素包括高并发症 (查尔森并发症指数3+),没有癌症病史,很少见到全科医生,骨髓瘤并发症,高风险细胞遗传学和晚期.
- 通过非计划途径诊断的患者表现出较低的生存率 (危险比1.44),尽管这对长期幸存者来说并不重要.
结论:
- 较高的并发症,晚期疾病和并发症与未计划的多发性骨髓瘤诊断有关.
- 非计划的诊断途径与多发性骨髓瘤患者的生存率降低有关.
- 促进早期检测和减少计划外诊断的策略可能会改善患者的生存率.
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