Research On Risk Factors Of DVT In Lower Limb And Its Prognostic Influence In Breast Cancer Patients After Operation

PurposeDeep vein thrombosis is one of the most common complications of breast cancer.It often complicates the pathogenetic condition,affects the treatment,increase the economic burden of patients,and reduce the life quality of patients.Therefore,it is particularly important that assess correctly to the risk of thrombosis in patients with effective measures in daily clinical work.By analyzing the patients' data admitted from January 2013 to June 2016,we hope to investigate the risk factors of breast cancer complicated with deep venous thrombosis of the lower limb,to explore the predictive significance of the thrombus risk assessment model for breast cancer patients,and also intend to understand the effect of lower limb venous thrombosis on the prognosis of breast cancer.MethodWe investigated 703 cases of breast cancer patients with deep venous thrombosis,who admitted to Tianjin Medical University Cancer Institute & hospital during January 2013 to June 2016 in this thesis.We selected 706 cases randomly of patients who with breast cancer while had not received concurrent venous thrombosis as our control group.Then investigating the risk factors and exploring the predictive value of serum markers for lower limb venous thrombosis,as well as applying the Khorana and Caprini risk assessment model in breast cancer patients via retrospective research method.All researched patients enrolled in this study were during 2013 to 2014.Follow-up data were collected and the end times were recorded.The effects of the venous thrombosis occurrence of the lower limb on the prognosis patients were analyzed.All data are processed with SPSS20.0 statistical software.The measurement data is explained by ±s and the results are verified by two independent samples t-test.The enumeration date is explained by percentage and the results are verified by ?2-test.We used ?2-test for novitiate analysis,used logistic regression model for multivariate analysis and used Kaplan-Meier method for survival analysis.Results1.In thrombosis group,the average time thrombosis occurred is 5.08 ± 3.042 days,mainly in the bilateral lower limbs(45.9%),the vast majority of patients with muscular calf vein thrombosis(98.4%).2.The results of single-factor analysis show that,the difference of age,obesity,menopause,diabetes,hypertension,coronary heart disease,pathological type,pathological stage,diagnostic methods,neoadjuvant chemotherapy,surgical method,time of operation and TC,LDL-C,apoB,Lpa,PT,APTT,PC,F-VIII,D-Dimer between thrombus group and control group is statistically significant(P<0.05).3.The results of multiple-factor analysis show that age,obesity,diagnostic methods,neoadjuvant chemotherapy,diagnostic methods,time of operation,Lp(a),PC,F-VIII,D-Dimer are independent risk factors.4.Between the two groups,there is no significant difference in Khorana RAM(p=0.207),while statistical difference in Caprini RAM(p = 0.000).5.The results of Kaplan-Meier method show that there is a significant difference in DFS between two groups(?2=3.979,P=0.046).Conclusion1.The age,diabetes,pathological type,diagnostic methods,neoadjuvant chemotherapy,operation time,laboratory indicators such as Lp(a),PC,F-VIII,D-Dimer are the independent risk factors for deep venous thrombosis in breast cancer.2.There is a certain internal relationship between TC,LDL-C,apoB and breast cancer patients with lower limb thrombosis,but these are not the independent risk factor.3.The Cabrini risk assessment model can predict the risk of thrombosis and provide appropriate prevention recommendations,but may lead to high risk assessment and over-prophylactic treatment.4.The disease-free survival is shorter to patients who are suffering from breast cancer with deep venous thrombosis.