关键词：血栓栓塞性疾病；肺癌；腺癌
【摘要】 目的 提高对肺癌合并血栓栓塞性疾病的认识。方法 从80～90年代由病理学细胞学确诊的1050例肺癌中，选择20例合并血栓栓塞性疾病的肺癌进行回顾性临床分析。结果 肺癌并发下肢深静脉血栓形成(DVT)12例(1.14%)；并发肺血栓栓塞(PTE)8例(4例同时有DVT)(0.76%)，并发伴动脉栓塞的无菌性血栓性心内膜炎(NBTE)4例(0.38%)，其中6例DVT和(或)PTE发生于肺癌确诊前2～6个月，3例NBTE于肺癌确诊前2～7个月出现脑栓塞或周围动脉栓塞表现。4例测定血纤维蛋白降解产物有3例增高，3例进行化疗，有1例用顺铂后未及时彻底水化发生DVT。在合并血栓栓塞性疾病的肺癌的病理类型中腺癌12例(55%)(其中包括肺泡癌3例，腺鳞癌2例)。结论 血栓栓塞性疾病并发于肺癌(以腺癌最多见)并不少见，有时可能是潜在肺癌的信号，如不明原因在一位既往健康者中发生，应警惕有肺癌等恶性肿瘤。肺癌并发血栓栓塞性疾病最重要的原因是血液处于高凝状态，而抗癌化学药物治疗及化疗过程中不及时彻底水化可成为促发因素。
Thrombosisdiseases and lung cancer
LU Weixuan, LILongyun, GAO Yan, et al.
( Department ofPulmonary Medicine, Peking Union Medical College Hospital, Peking Union Medical College,Chinese Academy of Medical Sciences, Beijing 100730,China )
【 Abstract 】 Objective To increase the awareness of lungcancer complicating thrombosis disease(TD). Methods 20 cases of lung cancer with TD which were from 1 050cases of lung cancer confirmed by pathology and cytology in 80 ′ s and 90 ′ s from a teaching hospital were retrospectively reviewed. Results Of the 20 cases, there were 8cases complicated with deep venous thrombosis(DVT);4 cases with pulmonary thromboembolism (PTE); 4 cases with DVT and PTE,and 4 cases with nonbacterial thrombotic endocarditis (NBTE).6 cases of DVT/PTE occurred 2 ～ 6 months before detection of lung cancer, 3 cases of NBTE had brainand peripheral artery embolism 2 ～ 7 months before detection of lung cancer. The pathology of 12 casesof lung cancer with TD was adenocarcinoma. Conclusions TD complicating lung cancer wasnot unusual and could be warning sign indicating occult lung cancer. Physician ought toalert to lung cancer or other cancers when facing aged healthy subjects of sudden TD underunknown origin.The most common physiologic type of lung cancer complicating TD was adenocarcinoma. Hypercoagulation state was the most important cause of TD complicatinglung cancer.
【 Keywords 】 Thrombosis disease; Lung cancer; Adenocarcinoma
肺癌和血栓栓塞性疾病之间存在一定的生物关系[1] ......
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