Clinical Study Of Malignant Tumor With Venous Thrombosis As The First Clinical Manifestation

Objective:To investigate the clinical characteristics,changes of some related biochemical indexes and imaging results of malignant tumor patients with venous thrombosis as the first clinical manifestation,so as to provide basis for the early diagnosis and treatment of malignant tumor.Methods:Retrospective analysis in January 2002-November 2017 in Shanxi Province people's hospital treated 73 cases with venous thrombosis for starting clinical manifestation to hospital see a doctor,was eventually diagnosed as malignant solid tumor of the clinical data and related biochemical indicators,the patients' age,gender,good hair parts and parts of the tumor thrombus and basic types of use cases(percentage)for categorical data analysis,and according to the range of medical reference values,the single-sample t-test was used to compare the differences between albumin,d-dimer and cholinesterase of patients and normal people.Results:1.Meet the criteria for a total of 73 cases,male,42 cases(57.5%),female,31 cases(42.5%),aged 21 to 86 years old(average age was 58 + 15),or the age of 40 patients with 66 cases(90.4%),all cases are VTE treated in hospital for unknown reasons,during the stay in hospital diagnosed as malignant tumor,including 30 cases(41.1%),the patient has a history of smoking,there are 45 cases(61.6%)patients were found by CT/PET-CT tumors.Among all the patients,64 cases(87.7%)were diagnosed as malignant tumors during the first hospitalization,and 9 cases(12.3%)were definitely diagnosed after multiple hospitalization,with the shortest time to thrombosis being 20 days and the longest being 8 months.Of all cancer patients,39 cases(53.4%)had metastatic disease at the time of diagnosis.There were 12 cases(16.4%)patients with a history of malignancy,and the history is more than 5 years,patients were not during radiotherapy,chemotherapy,etc during the treatment,there are 11 cases(15.1%)cases of thrombotic events,it found that the original at the same time with different degrees of metastasis,tumor recurrence in 1 case(1.4%)patients found new tumor thrombus incident.2.According to the location of thrombosis,all VTE patients were divided into: single site thrombosis patients 62 cases(84.9%),including lower extremity deep vein thrombosis 47 cases(64.4%),with the left leg deep vein,the most common in 29 cases(39.7%),pulmonary embolism,8 cases(11.0%),portal vein thrombosis in 5 cases(6.8%),upper limb thrombosis in 2 cases(2.7%).Eleven patients(15.1%)had multisite thrombosis.3.All cancer patients according to tumor location can be divided into: 28 cases of the digestive system tumors(38.4%),cervical thoracic tumor 15 cases(20.5%),urinary tract tumors,10 cases(13.7%),8 cases of gynecologic oncologists(11.0%),mesenchymal tissue tumor in 3 patients(4.1%),blood system tumor in 4 cases(5.5%),metastatic carcinoma of unknown primary tumor in 5 cases(6.8%).4.Comparing the difference between the albumin,d-dimer and cholinesterase of the patients and the patients: the albumin level of the patients was(36.12±4.89)lower than that of the healthy people(40.93±5.08)(t=5.743).P < 0.001);The d-dimer level of the patients(1742.11±1800.29)was significantly higher than that of the healthy patients(173.91±33.06)(t=3.617,p<0.001).The cholinesterase level of the patients(5595.27±2218.64)was significantly lower than that of the healthy(6748.46±1217.92)(t=7.470,p<0.001).Conclusion:In the process of clinical diagnosis and treatment,patients with unexplained VTE who have decreased albumin,decreased cholinesterase and increased D-dimer should be highly alert to the possibility of malignant tumor.