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J Thromb Haemost:Khorana评分不能预测肺癌患者的静脉栓塞风险

2016-10-23 MedSci MedSci原创

近期有研究表明,高风险Khorana评分不能预测肺癌患者的静脉血栓栓塞症风险。 基于研究发现,研究人员建议改进这类患者的风险分层方法,以进一步更有效得预防这类患者的VTE事件。 罗切斯特梅奥诊所的Aaron Mansfield说:患者准备开始化疗之前,都会评估VTE风险。到目前为止,评估癌症患者血栓形成风险的最好方式是Khorana风险评分。如果Khorana风险评分对某一类常见癌症患

近期有研究表明,高风险Khorana评分不能预测肺癌患者的静脉栓塞风险。

基于研究发现,研究人员建议改进这类患者的风险分层方法,以进一步更有效地预防这类患者的VTE事件。

罗切斯特梅奥诊所的Aaron Mansfield说:患者准备开始化疗之前,都会评估VTE风险。到目前为止,评估癌症患者血栓形成风险的最好方式是Khorana风险评分。如果Khorana风险评分对某一类常见癌症患者的预测效果不好,那么就需要寻找癌症特异性标志物来评估患者的VTE风险。

Mansfield和同事们对719例肺癌患者(平均年龄68岁;男性占52%)进行了研究,评估Khorana评分和VTE发病率之间的关联。

87%的患者为非小细胞肺癌,40.5%的患者有转移性疾病。次要终点为总生存率。

中位随访时间为15.2个月。超过四分之三(78.8%;n = 568例)的患者死亡。

83例(11.5%)患者发生了VTE,4例VTE患者没有发现决定性的Khorana得分。

研究人员没有发现高Khorana得分和VTE风险之间的联系(累积发生率:12.4%;95% CI,6.4-20.5;与中间得分的患者相比较(累积发生率:12.1%;95% CI,9.5-15))。Khorana得分处于中间的患者,其VTE发生率为85%。

虽然更高的得分不能预测VTE风险,但是却与全因死亡率风险独立相关(HR = 1.7; 95% CI, 1.4-2.2)。

原始出处:

Khorana Risk Score not predictive of VTE in lung cancer.Healio.October 18, 2016

Mansfield A, et al. Predictors of active cancer thromboembolic outcomes: validation of the Khorana score among patients with lung cancer.J Thromb Haemost. 2016;doi:10.1111/jth.13378.

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    2017-02-02 AspirantSuo
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    2017-04-23 fusion
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    2017-09-23 changfy
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