Diagnostic Value Of Wells Score,Geneva Score Combined With D-Dimer And Years Score For Pulmonary Embolism In Patients With Lung Cancer

Objective: To evaluate the diagnostic value of Wells Score,Geneva Score combined with D-dimer and YEARS Score for pulmonary embolism in patients with lung cancer.Methods: In this study,222 lung cancer patients underwent CTPA from January 1,2016 to December 31,2018 in the First Affiliated Hospital of Chongqing Medical University.The basic data of the patients were collected and the patients were classified into lung cancer combined with pulmonary embolism group and lung cancer group according to CTPA results.All patients were scored by Wells Score,Geneva Score and YEARS Score.The receiver operating characteristic(ROC)curves were generated and the Z test was applied to evaluate the diagnostic value by comparing the area under the ROC curves(AUC).The ROC curve of D-dimer was generated and the optimum critical value was calculated.Results: Totally 81(36.49%)patients had pulmonary embolism out of the 222 lung cancer patients.The AUC by Wells Score,Geneva Score,WellsScore+D-dimer,Geneva Score+D-dimer and YEARS Score were0.563(95% CI:0.485-0.640),0.537(95% CI:0.459-0.615),0.633(95% CI:0.557-0.708),0.626(95% CI:0.551-0.700)and 0.669(95% CI:0.598-0.739).The AUC of YEARS Score was significantly greater than that of Wells Score,Geneva Score(Z=1.96,2.44,both P<0.05).The heterogeneity of AUC between YEARS score and Wells Score+D-dimer,Geneva Score+D-dimer was not significant(Z=0.68,0.83,both P>0.05).The AUC by D-dimer was 0.790(95% CI:0.727-0.852).The optimum critical value of D-dimer was 2.97mg/L,and the sensitivity,specificity,positive predictive value and negative predictive value was 82.72%,71.63%,62.61% and 87.83%.Conclusion: The diagnostic value of YEARS score for pulmonary embolism in lung cancer patients is higher than Wells score and Geneva score.Pulmonary embolism can be excluded if YEARS score is negative.The diagnostic value of Wells score,Geneva score combined with D-dimer is higher than that of original scores.The above five scoring methods need to be further revised for pulmonary embolism in patients with lung cancer.The optimum critical value of D-dimer is 2.97mg/L with high sensitivity,specificity,positive predictive value and negative predictive value.