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Original Research: Lung Cancer |

Prevalence and Associations of VTE in Patients With Newly Diagnosed Lung CancerVTE in Patients With Newly Diagnosed Lung Cancer

Yuhui Zhang, MD, PhD; Yuanhua Yang, MD, PhD; Wenhui Chen, MD; Lijuan Guo, MD, PhD; Lirong Liang, MD, PhD; Zhenguo Zhai, MD, PhD; Chen Wang, MD, PhD; for the China Venous Thromboembolism (VTE) Study Group
Author and Funding Information

From the Beijing Institute of Respiratory Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

CORRESPONDENCE TO: Chen Wang, MD, PhD, Beijing Institute of Respiratory Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongtinan Rd, Chaoyang District, Beijing, 100020, Beijing Hospital, Ministry of Health, China; e-mail: zhangyhcy86@hotmail.com


*A complete list of study participants is located in e-Appendix 1.

FUNDING/SUPPORT: This study was supported by China Key Research Projects of the 12th National Five-Year Development Plan [Grant 2011BAI11B00], Wu Jieping Medical Foundation [Grant 320.6750.12623], and the Natural Science Foundation of China [Grant 30810103904].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(3):650-658. doi:10.1378/chest.13-2379
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BACKGROUND:  The risk of VTE before anticancer therapy in patients with lung cancer is not well defined.

METHODS:  A total of 673 hospitalized patients with newly diagnosed lung cancer were examined for VTE within 1 week after admission at five hospitals between January 2009 and January 2011. Additionally, VTE diagnoses within the last 3 months were reviewed. All VTE events were confirmed with imaging studies. Blood cell count and serum carcinoembryonic antigen (CEA) levels were measured before initial treatment.

RESULTS:  VTE events occurred in 89 of the 673 patients (13.2%) enrolled in this study. Forty-two patients (6.2%) developed lower extremity DVT alone, 33 patients (4.9%) developed pulmonary embolism (PE) alone, and 14 patients (2.1%) developed both DVT and PE. By multivariate logistic regression analysis, distant metastasis (OR, 2.2; 95% CI, 1.2-3.9) and leukocytosis (OR, 2.8; 95% CI, 1.5-5.4) were significantly associated with DVT, adenocarcinoma (OR, 2.1; 95% CI, 1.1-4.4) and anemia (OR, 4.6; 95% CI, 1.4-14.5) were significantly associated with PE, and an elevated CEA level in tertiles was linearly associated with PE (P for trend = .06). The area under the receiver operating characteristic curve for the prognostic or diagnostic CEA values was 0.68 (95% CI, 0.59-0.76; P < .001).

CONCLUSIONS:  The prevalence of VTE was high in patients with newly diagnosed lung cancer. In patients with lung cancer, the factors associated with DVT might be different from those associated with PE. An elevated CEA level might facilitate the identification of patients at a higher risk of developing PE.

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