Analysis Of Risk Factors Of Venous Thromboembolism In Patients With Lung Cancer And Correlation Analysis Of TCM Syndrome Types

ObjectTo analysis the risk factors of venous thromboembolism in patients with lung cancer and discuss the correlation between TCM syndrome types and incidence of VTE in lung cancer patients.MethodThe study collected lung cancer patients who have hospitalized in the Department of Oncology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences from July 2015 to July 2020.The data comes from the electronic medical record database.Among the enrolled cases,patients with VTE were included in the derivation group,and those patients without VTE were included in the validation group.The study collected the general data,clinical data,cancer-related information,biological indicators,TCM syndromes and other information of all patients,and utlize retrospective case-control research approach to make comparation between the information of the two groups to explore the conductors leading to the incidence of VTE in lung cancer patients and analyze the condition of VTE events and TCM syndromes' distribution in the derivation group.Result1 Research figure:According to the inclusion and exclusion criteria,a total of 192 patients were included,consisting of 48 patients in the derivation group(VTE group)and 144 patients in the validation group(non-VTE group).2 The relationship between the incidence of VTE and general data:The average age of patients are 63.97±10.49 years,64.94±9.73 years in derivation group and validation group respectively.According to statistics,it was found that the 55-74 year-old middle-aged and elderly patients in the VTE group accounted for more(64.6%),and middle-aged patients aged 45-54 have a higher risk of VTE(p<0.05).The number of people drinking are 16(33.3%)and 15(10.4%)in the VTE group and non-VTE group respectively.According to statistics,the proportion of people drinking in the VTE group is significantly higher(p?0.05),and multivariate analysis shows that drinking is an independent risk factor(OR=5.02).3 The relationship between the incidence of VTE and clinical data:There are 7 patients with chronic obstructive pulmonary disease in the VTE group(14.6%),and 5 in the control group(3.5%).According to statistics,it is found that patients in the VTE group are combined The proportion of people with chronic obstructive pulmonary disease was significantly higher(p<0.05),and it is recognized as an independent risk feature by multivariate analysis(OR=10.47).4 The relationship between the incidence of VTE and cancer-related conditions:the major pathological type of patients in the VTE group is adenocarcinoma(n=26,54.2%).All the patients in VTE group were at ?-? stage utilizing TNM catagory,while the proportion of patients with the lymph node stage of N3 in VTE group is obviously higher than those in non-VTE group(p<0.05).Also the N3 stage is analyzed as an independent risk factor by multivariate analysis(OR=5.67).The risk of VTE in lung cancer patients with distant metastasis is higher(p<0.05),which is nearly 6 times the risk of VTE in patients in validation group.Compared with non-VTE group,the proportion of patients with adrenal metastasis was much higher in VTE group(20.8%vs 6.2%,p<0.05).5 The relationship between the incidence of VTE and biological indicators:The blood glucose and urea nitrogen levels of patients in VTE group are significantly higher than validation group(p<0.05),and the blood glucose level was an independent risk factor for the occurrence of VTE in lung cancer patients through multivariate analysis(OR=2.92).The average time of prothrombin and activated partial thromboplastin in the VTE group are significantly shoter than those in validation group(p<0.05).6 VTE incidence:Among the 48 patients in the VTE group,33 patients(68.75%)had upper limb venous thromboembolism,14 patients(29.17%)had lower limb venous thromboembolism,and one patient had pulmonary embolism with left lower limb venous thromboembolism.(2.08%).There were 29 cases of upper extremity venous thromboembolism related to central venous catheterization,accounting for 60.42%of the overall VTE events and 87.88%of patients with peripherally inserted central venous catheters in VTE group.The median time from the diagnosis of lung cancer to the onset of VTE is 9.83 months,while there is the considerably large amount(n=32,66.7%)of patients with lung cancer occurring VTE events after over 6 months of the diagnosed time of malignance.7 Distribution of TCM syndromes in patients with VTE:Distribution of TCM syndromes in VTE patients:Phlegm-dampness syndrome>Qi deficiency syndrome>Blood stasis syndrome 10 persons>Heat toxin syndrome>Yin deficiency syndrome>Qi stagnation syndrome.Differed from validation group,the patients diagnosed as blood stasis syndrome and heat toxin syndrome account for much lager proportion in VTE group(p<0.05).Distribution of TCM syndrome types in VTE patients:Qi stagnation and blood stasis syndrome>phlegm and blood stasis syndrome>Qi deficiency and blood stasis syndrome>phlegm-heat obstructing the lung syndrome>Yin deficiency toxin-heat syndrome.There shows much bigger proportion of phlegm and blood stasis inter-combination syndrome,phlegm-heat obstructing the lung syndrome in derivation group than those in validation group(p<0.05).By using multivariate analysis,the phlegm-heat obstructing the lung syndrome is considered as an independent risk feature of VTE incidenve in lung cancer patients(OR=9.31).Conclusion1.Drinking alcohol,combined with chronic obstructive pulmonary disease,lymph node staging as N3,distant metastasis,blood sugar,and phlegm-heat obstructing lung syndrome are independent risk factors for the incidence of VTE in lung cancer patients.2.The baseline TCM syndromes of lung cancer patients with VTE are phlegm-dampness syndrome,qi deficiency syndrome,blood stasis syndrome,and heat toxin syndrome.The most common kinds of syndromes listed by proportion are Qi stagnation and blood stasis syndrome,phlegm and blood stasis syndrome,qi deficiency and blood stasis syndrome,and phlegm-heat blocking lung syndrome.3.The occurrence time of VTE is usually 6 months after the diagnosis of lung cancer.For lung cancer patients in the middle and late stages of treatment,the risk of VTE should be vigilant.