Abstract：Objective: To investigate the predictive value of Wells score combined with adjusted D-dimers for lung cancer complicated with acute pulmonary embolism. Methods: From November 2013 to November 2020, 130 lung cancer patients suspected for APE were admitted to the affiliated hospital of Chengde Medical University. The predictive value of Wells score, adjusted D-dimer and combination of the above were respectively estimated. Results: Among 130 APE suspected cases, 67 were confirmed. After Wells scoring, patients were divided into low-potential group (41 cases), medium-potential group (72 cases), high-potential group (17 cases), and confirmed APE were 14 cases,39 cases,33 cases respectively. The sensitivity of diagnosis of lung cancer combining APE was 20.90%,58.21%,20.90% respectively. The specificity was 57.14%,47.62%, 95.24% respectively. The positive predictive values were 34.15%,54.17%, 82.35% respectively. The negative predictive values were 65.85%,45.83% and 7.65% respectively. The adjusted D-dimer value (981ng/mL), compared with the traditional D-dimer value (500ng/mL), has an increased specificity of diagnosis of lung cancer with APE (42.86% vs23.81%, P<0.05). To the negative patients whose Wells score revealed low potential of combining adjusted D-dimer negative, the negative predictive value of diagnosis of lung cancer combining APE can rise to 99.45%. ROC curves of D-dimers in 130 lung cancer patients with suspected APE reveal that the critical value of D-dimer is 1975ng/mL, higher than the conventional 500ng/mL. Conclusion: Wells score of low potential of combining adjusted D-dimer negative is effective to exclude suspected APE patients with lung cancer. Lung cancer patients with APE often have a high level of D-dimer.
王少飞, 陈文丽, 李金玲, 杨林瀛, 贾睿奕, 庞桂芬. Wells评分联合校正的D-二聚体对肺癌合并急性肺栓塞的预测价值[J]. 河北医学, 2021, 27(12): 2023-2026.
WANG Shaofei, CHEN Wenli, LI Jinling, et al. The Predictive Value of Wells Score Combined with Adjusted D-Dimers for Lung Cancer with Acute Pulmonary Embolism. HeBei Med, 2021, 27(12): 2023-2026.
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2021, Vol. 27 
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