CAJ | 학술논문

目的分析以下肢深静脉血栓形成为主要临床表现的恶性肿瘤患者的临床特点.方法从2010年5月至2012年1月对下肢深静脉血栓形成的患者进行肿瘤筛查,分析肿瘤筛查阳性患者的年龄,性别,血栓形成部位,肺栓塞的发生,癌症标志物、临床症状特点等,并与肿瘤筛查阴性患者进行比较.结果本组入选接受肿瘤筛查84例患者,均为无明显相关危险因素的下肢深静脉血栓形成患者.男43例,女41例.平均年龄(62±16)岁.共发现恶性肿瘤8例,占9.52％.其中肺癌3例,胰头癌1例,软组织肉瘤1例,卵巢癌1例,结肠癌1例,子宫颈癌1例.恶性肿瘤组患者平均年龄(51±25)岁,筛查阴性组平均年龄(64±15)岁,2组差异无统计意义(t=1.92,P=0.18).恶性肿瘤患者组中央型深静脉血栓形成比例为100％,高于筛查阴性组的63.17％(x2=4.42,P=0.047).肿瘤筛查阳性组血清肿瘤标志物阳性率为62.5％,高于筛查阴性患者的10.53％(x2=14.95,P=0.002).恶性肿瘤组CTA检查发现肺栓塞5例,均为次大面积肺栓塞,发生率为62.5％,高于肿瘤筛查阴性组18.4％(x2=8.04,P=0.01).发现肿瘤后中位生存时间为6个月.结论以下肢深静脉血栓形成为最初临床主要表现的恶性肿瘤患者的特点为大多为近心端深静脉血栓,肺栓塞比例高,腺癌多见.
목적 분석이하지심정맥혈전형성위주요림상표현적악성종류환자적림상특점.방법 종2010년5월지2012년1월대하지심정맥혈전형성적환자진행종류사사,분석종류사사양성환자적년령,성별,혈전형성부위,폐전새적발생,암증표지물、림상증상특점등,병여종류사사음성환자진행비교.결과 본조입선접수종류사사84례환자,균위무명현상관위험인소적하지심정맥혈전형성환자.남43례,녀41례.평균년령(62±16)세.공발현악성종류8례,점9.52％.기중폐암3례,이두암1례,연조직육류1례,란소암1례,결장암1례,자궁경암1례.악성종류조환자평균년령(51±25)세,사사음성조평균년령(64±15)세,2조차이무통계의의(t=1.92,P=0.18).악성종류환자조중앙형심정맥혈전형성비례위100％,고우사사음성조적63.17％(x2=4.42,P=0.047).종류사사양성조혈청종류표지물양성솔위62.5％,고우사사음성환자적10.53％(x2=14.95,P=0.002).악성종류조CTA검사발현폐전새5례,균위차대면적폐전새,발생솔위62.5％,고우종류사사음성조18.4％(x2=8.04,P=0.01).발현종류후중위생존시간위6개월.결론 이하지심정맥혈전형성위최초림상주요표현적악성종류환자적특점위대다위근심단심정맥혈전,폐전새비례고,선암다견.
Objectives To study the characteristics of malignance patients with initial presentation of deep venous thrombosis (DVT) of the lower limb.Methods This study screened neoplasm among patients with deep venous thrombosis between May 2010 and January,2012.The characteristics of location of deep venous thrombosis,incidence of pulmonary embolism,serum tumor marker,gender,ages were evaluated.Results 84 DVT patients were recruited,including 43 male and 41 males.Malignant neoplasms were detected in 8 patients with incidence of 9.52％,including lung cancer in 3 patients,pancreas cancer,soft tissue sarcoma,ovarian cyst carcinoma,cervical cancer,and colon cancer in one each patient.Proximal deep venous thrombosis presented in all patients with malignant neoplasm.Positive rate of serum biomaker was 62.5％ in neoplasm group which was higher than that of 10.53％ in screen negative group (P =0.002).Sub-massive pulmonary embolism was detected by computer tomography angiography in 5 patients in malignant neoplasm group (62.5％),which is higher than that of 18.40％ in screen negative patients (P =0.01).Median lifetime of patients with neoplasm after diagnosis was 6 months.Conclusions Most patients with DVT malignant neoplasm were of adenocarcinoma and often suffered from pulmonary embolism.