Clinical And Imaging Study Of Pulmonary Embolism In Patients Of Cancer:Analysis Of28Cases

Objective Venous thromboembolism is a common complication of cancer. The incidence rate is rising in recent years. Venous thromboembolism, especially pulmonary embolism is the second leading cause of death in cancer patients due to its high fatality rate, only to the malignancy itself. It increases the difficulty of treatment and the lives of patients are threatened. At present, the prevention and treatment of pulmonary embolism can not only improve the prognosis of patients with malignant tumor, but also improve the quality of life. Up to now, the tumor associated pulmonary embolism imaging and clinical domestic studies reported rarely. The retrospective analysis of28cases of pulmonary embolism complicated with cancer, aims to explore the imaging and clinical characteristics of pulmonary embolism with cancer.Methods The88patients(2005.01-2009.11) diagnosed with PE by CTPA were divided to cancer group (28cases) and non-cancer group (60cases) according with/without pathology confirmed cancer. The emboli site, density, and right heart function signs were analyzed. The clinical manifestations, PE occurrence time, type of tumor, metastasis and chemotherapy and operation history were collected in cancer group. Results There is no age and gender difference between cancer and non-cancer group. Malignant tumors complicated with PE incidence is ranked in the top three were lung cancer (32.1%), bladder cancer (10.7%) and multiple myeloma (10.7%), the first of the histologic types of lung carcinoma is adenocarcinoma. There were14cases with metastasis, accounted for50%. Before PE occurred,12patients were carried out chemotherapy,3cases of radiotherapy,11cases of operation. In CTPA, the cancer group found exudative lesions in22patients (78%), accompanied by pleural effusion in19cases (64%); non-cancer group found exudative lesions in34patients (57%), accompanied by pleural effusion in21cases (35%), showing a significant difference between two groups. In our study there were22central PE cases(78%) in cancer group and34central PE cases (57%) in non-cancer group(P<0.05).The cancer patients are at a higher risk to develop central PEs. There was no statistically different in thrombus density, embolism index and right ventricular function indicators.Conclusion The malignant tumor due to operation, radiotherapy and chemotherapy and tumor itself factors, prone to pulmonary embolism. The occurrence of pulmonary embolism is various in different tumor types. The lung cancer, bladder cancer and multiple myeloma are top three tumors, especially adenocarcinomas produced mucus. The CTPA image data found central pulmonary embolism probability higher in cancer patients than non-cancer patients. PEs in cancer patients are more prone to pleural effusion and pulmonary exudative lesions. The embolic density has no obvious statistical difference.