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

doi:10.3969/j.issn.1006-6233.2021.12.019

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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.

Key words： Pulmonary embolisms Corrected D-dimers Lung cancer Wells score

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.12.019 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I12/2023

[1] 杨欢欢,陈虹.肺癌合并肺栓塞的研究进展[J].中华结核和呼吸杂志,2020,43(7):577~581.
[2] 张海霞.简易Wells临床评分结合年龄校正D-二聚体标准对急诊急性肺栓塞的诊断价值[J].中国急救医学,2016,36(8):712~715.
[3] Hua X,Han SH,Wei SZ,etal.Clinical features of pulmonary embolism in patients with lung caner:a meta-analysis[J].PLoS One,2019,14(9):223~230.
[4] Chen C,Li G,Liu Y,et al.A new D-dimer cut off vaule to improve the exclusion of deep vein throm-bosis in caner patients[J].Asian Pacific Journal of Cancer Prevention,2014,15(4):1655~1658.
[5] VanHerk-Sukel MP,Shantakumar S,Penning-van Beest FJ,et al.Pulmonary embolism,myocardial infarction,and ischemic stroke in lung cancer patients:results from a longitudinal study[J].Lung,2013,191(5):501~509.
[6] Anagnostopoulos I,Lagou S,Spanorriga MK,et al.Epidemiology and diagnos is of pulmonary embolism in lung cancer patients:is there arole for ageadjusted D-dimers cutoff?[J].Thromb Thrombolysis,2020,49(4):572~577.
[7] Michael B Streiff.Anticoagulation in the management of venousthromboem bolism in the can cerpatient[J].Thromb Thrombolysis,2011,31(3):282~294.
[8] 张林,李博,张晨,等.D-二聚体和Wells评分在主动脉夹层和急性肺栓塞鉴别诊断中的应用[J].中国老年学杂志,2017,37(3):596~598.
[9] Chen C,Li G,Liu Y D,et al.A new D-dimer cutoff value to improve the exclusion of deep vein thrombosis in cancer patients[J].Asian Pac Cancer Prev,2014,15(4):1655~1658.
[10] Lee AY,Julian JA,Levine MN,et al.Clinical utility of a rapid whole-blood D-dimer assay in patients with cancer who present with suspected acute deep venous thrombosis[J].Ann Intern Med,1999,131(6):417~423.
[11] 张盛斌,张淇钏,林茂煌,等.Wells评分联合年龄校正D-二聚体对住院患者急性肺栓塞的诊断价值[J].国际呼吸杂志,2020,40(1):25~29.