卵巢癌术前静脉血栓栓塞症发生的危险因素

Risk Factors for Preoperative Venous Thromboembolism of Ovarian Cancer

摘要: 目的：讨论卵巢恶性肿瘤患者在手术前发生静脉血栓栓塞的危险因素。方法：搜集2018年1月1日至2021年3月21日在山东省立医院妇科进行手术的卵巢癌患者共178例，包括45例术前发生静脉血栓的患者和133例术前未发生静脉血栓的患者，回顾性分析卵巢癌在术前发生静脉血栓栓塞症的危险因素。结果：单因素分析提示肿瘤直径、D-二聚体、病理分期、CA125和病理类型的差异有统计学意义(P < 0.05)；血小板、年龄、腹水、心血管疾病史的差异无统计学意义(P > 0.05)。多因素分析提示年龄、D-二聚体、病理类型和肿瘤直径是卵巢癌患者在术前发生静脉血栓栓塞症的独立危险因素。ROC曲线分析提示可以联合应用肿瘤分期、D-二聚体和病理类型预测卵巢癌患者术前静脉血栓栓塞症的发生，并且具有一定的诊断效能。结论：肿瘤直径、D-二聚体、病理分期、CA125和病理类型是卵巢癌患者在术前发生静脉血栓栓塞的危险因素，其中D-二聚体、肿瘤分期和病理类型对于手术前的卵巢癌患者及早发现血栓形成具有临床诊断意义。

Abstract: Objective: To discuss the risk factors for the occurrence of venous thromboembolism in patients with ovarian cancer before surgery. Methods: A total of 178 ovarian cancer patients who received surgery at the Department of Gynecology, Shandong Provincial Hospital from January 1, 2018 to March 21, 2021, including 45 patients with preoperative venous thrombosis and 133 patients without preoperative venous thrombosis, were collected to retrospectively analyze the risk factors for the occurrence of venous thromboembolism in ovarian cancer before surgery. Results: Univari-ate analysis suggested statistically significant differences in tumor diameter, D-dimer, pathological stage, CA125 and pathological type (P < 0.05); no statistically significant differences in platelets, age, ascites, and history of cardiovascular disease (P > 0.05). Multifactorial analysis suggested that age, D-dimer, pathology type and tumor diameter were independent risk factors for preoperative venous thromboembolism in ovarian cancer patients, and ROC curve analysis suggested that tumor stage, D-dimer and pathology type could be combined to predict the occurrence of preoperative ve-nous thromboembolism in ovarian cancer patients with certain diagnostic efficacy. Conclusions: Tumor diameter, D-dimer, pathological stage, CA125 and pathological type are risk factors for pre-operative venous thromboembolism in ovarian cancer patients, among which D-dimer, tumor stage and pathological type have clinical diagnostic significance for early detection of thrombosis in ovar-ian cancer patients before surgery.