Analysis on risk factors of lung cancer complicated with pulmonary embolism

Clin Respir J. 2021 Jan;15(1):65-73. doi: 10.1111/crj.13270. Epub 2020 Sep 28.

Abstract

Introduction: Pulmonary embolism (PE) is a potentially fatal complication and its morbidity together with fatalness will further increase when in patients with malignant tumors. Fast and accurate early diagnosis of PE thus seems considerably important.

Objective: To explore the risk factors of lung cancer complicated with PE.

Materials and methods: A retrospective cohort study consisted of 40 lung cancer patients with PE (PE group) and 60 lung cancer patients without PE (non-PE group) were analyzed.

Results: The white blood cell (WBC) count, D-dimer and low-density lipoprotein (LDL) were higher in PE group than those in non-PE group (P < 0.05), whereas the arterial partial pressure of oxygen (PaO2 ) in PE group was lower than that in non-PE group (P < 0.05). Carcinoembryonic antigen (CEA) level between two groups also exhibited statistical difference (P < 0.05). Those lung adenocarcinoma patients with stages III and IV tumor, coupled with deep venous thrombosis (DVT), having experienced bevacizumab treatment or platinum-based chemotherapy more likely suffered from PE (P < 0.05). The multivariate analysis revealed that high D-dimer, chemotherapy, DVT, stages III to IV, adenocarcinoma were independent risk factors associated with PE (P < 0.05). The overall survival time of patients in case group was significantly shorter than that in the control group with a median survival duration being 10.5 months (95%CI, 8.95-12.05) and 16.8 months (95%CI, 14.62-18.98), respectively, (P < 0.01).

Conclusions: High D-dimer, chemotherapy, DVT, stages III to IV and adenocarcinoma might have a positive correlation with PE, meanwhile, PE always predicted a poor prognosis in lung cancer patients.

Keywords: lung cancer; pulmonary embolism; retrospective study; risk factors.

MeSH terms

  • Adenocarcinoma of Lung*
  • Humans
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / epidemiology
  • Pulmonary Embolism* / complications
  • Pulmonary Embolism* / diagnosis
  • Pulmonary Embolism* / epidemiology
  • Retrospective Studies
  • Risk Factors