Investigation Of Risk Factors For Venous Thromboembolism In Women With Gynecologic Malignancies

Objective:In this study,statistical methods were used to retrospectively analyze the clinical data of patients with gynecological malignant tumors,to explore the related risk factors of gynecological malignant tumors complicated with venous thromboembolism,and to provide theoretical basis for clinical prevention and treatment.it is helpful to identify high-risk groups more accurately and efficiently,actively prevent thrombosis and reduce the incidence of venous thromboembolism.Methods:A total of 140 patients with gynecological malignant tumors(ovarian cancer,endometrial cancer,cervical cancer,vulvar cancer)complicated with venous thromboembolism(61 cases of ovarian cancer,49 cases of endometrial cancer,24 cases of cervical cancer and 6 cases of vulvar cancer)were selected from January 2018 to August 2022 in Qingdao University affiliated Hospital.The patients with gynecological malignant tumor without venous thromboembolism in the same period were randomly selected by computer random method at 1:1 as the control group.The case-control study was adopted.The statistical analysis was carried out by SPSS26.0 software.The relationship between the research factors and gynecological malignant tumor complicated with venous thromboembolism was analyzed by univariate analysis.The normality and homogeneity of variance were tested before the test of measurement data.The normal distribution data is expressed by x±s,then the t-test is used,and the non-normal distribution data is expressed by the median(quartile),and then the Mann-WhitneyU test is used.The counting data are selected by χ2 test.The statistically significant factors were analyzed by Logistic regression model to determine the independent risk factors of gynecological malignant tumors complicated with venous thromboembolism.After that,the meaningful hematological indexes of univariate analysis were substituted into the ROC curve(receiver operating characteristic curve),and the predictive value of each index was compared.According to the Caprini and Padua risk assessment models,the patients were graded and stratified,and the application value of the two models in the risk assessment of gynecological malignant tumors complicated with venous thromboembolism was compared by ROC curve.Results:(1)The age of onset in the case group was mainly from 61 to 70 years old.(2)The results of univariate analysis showed that there were significant differences in age,menopausal state,tumor stage,histopathological grade,anticoagulant prophylaxis and chemotherapy within 6 months between the case group and the control group(P<0.05).The results of multivariate Logistic regression analysis showed that there were significant differences in menopause(OR=5.034,95%CI=2.773～9.138)and tumor stage(OR=3.687,95%CI=2.013～6.752)between the case group and the control group.(3)The results of univariate analysis of hematological indexes showed that there were significant differences in FIB(fibrinogen),D-dimer and PLT(platelet)between the case group and the control group.The result of substituting ROC curve shows that the area under the curve of FIB is 0.651 and the area under the curve of D-dimer is 0.612.The area under the curve of PLT is 0.627.The area under the curve diagnosed by FIB,D-dimer and PLT was 0.681.(4)VTE risk score and stratification were performed on the patients,and substituted into the ROC curve,the results showed that the areas under the curve of Caprini model and Padua model were 0.661 and 0.604 respectively.Conclusion:(1)The high incidence age of gynecological malignant tumor complicated with venous thromboembolism was 61 to 70 years old.(2)Age,menopause,tumor stage,histopathological grade,chemotherapy within 6 months and anticoagulant prophylaxis are the influencing factors of gynecological malignant tumor complicated with VTE.Menopause and tumor staging are independent risk factors of gynecological malignant tumors complicated with VTE.(3)Hematological indexes FIB,D-dimer and PLT were related to gynecological malignant tumors complicated with VTE,and had certain predictive value for gynecological malignant tumors complicated with VTE.The order from high to low was FIB,PLT and D-dimer.The combined prediction value of the three indicators for VTE is better than that of individual prediction.(4)The use of Caprini risk assessment model for VTE risk stratification of patients with gynecological malignant tumors is better than Padua model.