EGFR-和alk -突变肺腺癌患者的血栓栓塞风险

Suna Kavurgacı, Yasemin Söyler, Pınar Akın Kabalak, Derya Kızılgöz, Ülkü Yılmaz
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摘要

在这项研究中,我们研究了携带表皮生长因子受体(EGFR)和间变性淋巴瘤激酶(ALK)基因突变的非小细胞肺癌患者静脉血栓栓塞(VTE)的发生率、VTE的相关危险因素以及VTE对总生存率的影响。该研究纳入了年龄大于18岁、经组织学证实为局部晚期或晚期腺癌的患者,并于2014年1月至2019年12月在我们的中心进行了随访。这些患者被分为两组:一组包括突变阳性个体和另一组突变阴性个体。我们检查了影响静脉血栓栓塞发生的因素,评估了静脉血栓栓塞的发生率,并比较了总生存率的差异。单因素Cox回归分析显示,VTE的独立预测因素为转移数量(危险比[HR]: 3.784;95%置信区间[CI]: 2.198 –6.515;P & lt;0.001)和EGFR外显子21突变的存在(HR: 2.386;95%置信区间:1.276;4.462;P = 0.006)。然而,在多变量分析中,只有合并症的数量与VTE风险增加相关(HR: 3.462;95% CI: 1.977 &6.060;P & lt;0.001)。EGFR外显子21突变阳性肺腺癌患者有必要考虑静脉血栓栓塞的发生风险。医生应该对这些患者潜在静脉血栓栓塞的筛查、预防和随访保持警惕。
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Thromboembolism risk in patients diagnosed with EGFR- and ALK-mutant lung adenocarcinoma
In this study, we investigated the incidence of venous thromboembolism (VTE), related risk factors for VTE, and the effect of VTE on overall survival in patients with non-small-cell lung cancer harboring epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) gene mutations. The study included patients older than 18 years of age who were diagnosed with histologically proven locally advanced or advanced-stage adenocarcinoma and were followed in our center between January 2014 and December 2019. These patients were divided into two groups: one comprising mutation-positive individuals and the other mutation-negative individuals. We examined factors influencing the occurrence of VTE, assessed the incidence of VTE, and compared the differences in overall survival. Univariate Cox regression analysis revealed that the independent predictors of VTE were the number of metastases (Hazard ratio [HR]: 3.784; 95% confidence interval [CI]: 2.198 &ndash; 6.515; P < 0.001) and the presence of EGFR exon 21 mutations (HR: 2.386; 95% CI: 1.276 &ndash; 4.462; P = 0.006). However, in multivariate analysis, only the number of comorbidities was associated with an increased risk for VTE (HR: 3.462; 95% CI: 1.977 &ndash; 6.060; P < 0.001). It is essential to consider the risk of VTE development in patients with EGFR exon 21 mutation-positive lung adenocarcinoma. Physicians should be vigilant in terms of screening, prophylaxis, and follow-up for underlying VTE in these patients.
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