Risk factors of lung cancer with pulmonary embolism:a meta-analysis

doi:10.3969/j.issn.1004-583X.2021.12.001

Abstract

Abstract:

Objective To evaluate the risk factors of lung cancer with pulmonary embolism systematically. Methods By January 2021, pertinent literature on risk factors of lung cancer with pulmonary embolism were included form PubMed, Embase, CNKI, Wanfang database and others. Two researchers independently completed the literature screening, data extraction and quality evaluation of the included literature. RevMan5.4 software and Stata16.0 software were used to conduct meta-analysis. Results A total of 25 studies involving 3480 patients were included. Meta-analysis results show that the risk factors of pulmonary embolism in patients with lung cancer include adenocarcinoma (OR =2.06, 95% CI [1.75, 2.44], P <0.01), tumor stage (stage Ⅲ-Ⅳ)( OR =2.67, 95% CI [2.19, 3.26], P <0.01), chemotherapy (OR =2.69, 95% CI [2.08, 3.47], P <0.01), deep vein catheterization (OR =2.66, 95% CI [1.68, 4.19], P<0.01), albumin<30 g/L(OR=6.65, 95% CI [2.91, 15.18], P<0.01), D dimer>500 g/L (OR =5.87, 95% CI [2.12, 16.27], P <0.01), white blood cells >11×10⁹/L(OR =8.26, 95% CI [4.50, 15.13], P <0.01) and chronic obstructive pulmonary disease(OR =1.51, 95% CI [1.16, 1.95], P <0.01). Conclusion The risk factors for pulmonary embolism with lung cancer are adenocarcinoma, tumor staging (stage Ⅲ-Ⅳ), chemotherapy, deep venous catheterization, albumin <30 g/L, D-dimer >500 ng/mL, white blood cell >11×10⁹/L and chronic obstructive pulmonary disease(COPD). Due to limited quality and quantity of the included studies, more high-quality articles are needed to verify the conclusions.

Key words: lung neoplasms, pulmonary embolism, risk factors, meta-analysis

CLC Number:

R734.2

Huang Ping, Liu Hanyun, Li Yuhong. Risk factors of lung cancer with pulmonary embolism:a meta-analysis[J]. Clinical Focus, 2021, 36(12): 1061-1066.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.12.001

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I12/1061

Figures/Tables 7

作者	年份	例数		危险因素	NOS 评分
作者	年份	病例组	对照组	危险因素	NOS 评分
Cui^[4]	2021	40	60	①②③⑨⑩⑪⑫⑭	8
Lee^[5]	2009	40	80	①②⑩⑪⑫	8
Ma^[6]	2017	30	60	①②⑨⑩⑪⑫	9
Junjun^[7]	2020	53	53	①②③⑨⑩⑪⑫	9
Xiong^[8]	2020	95	98	①②⑨⑫	8
Zhang^[9]	2014	47	626	①⑨⑩⑪	9
唐开华^[10]	2017	32	64	①②③⑤⑥⑦⑧⑨⑩⑫⑭	8
崔凯^[11]	2020	38	200	①②④⑫⑭	9
张琳^[12]	2015	57	57	①②④⑬	8
曹洁^[13]	2019	45	45	①②③⑩	7
朱佑明^[14]	2016	46	46	①②③④⑨⑩⑫⑬⑭	8
朱璐^[15]	2018	51	153	①②③⑥⑪⑫⑬	9
李娜^[16]	2014	23	46	①②③④⑤⑥⑦⑧⑨⑩⑫⑭	9
李广生^[17]	2017	28	56	①②③⑤⑦⑨⑩⑪⑫⑭	8
熊露^[18]	2014	53	43	①⑬	7
王峻^[19]	2011	54	162	①②③④⑧⑨⑩⑪⑫⑬⑭	9
田学涛^[20]	2017	32	32	①②③④⑩⑫⑭	8
石宗华^[21]	2015	35	105	①②③④⑥⑦⑧⑨⑩⑫⑭	9
罗天舒^[22]	2017	39	43	①②	7
肖芳芳^[23]	2017	37	37	①④⑫⑬⑭	8
褚贵丽^[24]	2020	12	48	①②③⑩⑬	8
赵娜^[25]	2017	72	72	①②	9
赵秋红^[26]	2013	9	89	①③⑥	8
那文娟^[27]	2019	58	116	②④⑩⑪⑫⑬	9
邱冬^[28]	2018	21	42	①②⑪⑫	7

相关指标	纳入研究数量	异质性检验		效应模型	Meta分析结果
相关指标	纳入研究数量	$P$ 值	$I 2$ 值	效应模型	$OR$ (95% $CI$ )	$P$ 值
化疗	13篇^{[4, 7, 10, 13-17, 19-21, 24, 26]}	0.06	40%	固定	2.69(2.08~3.47)	<0.01
深静脉置管	9篇^{[11-12, 14, 16, 19-21, 23, 27]}	0.02	57%	随机	2.66(1.68~4.19)	<0.01
白蛋白<30 g/L	3篇^{[10, 16-17]}	0.71	0%	固定	6.65(2.91~15.18)	<0.01
D二聚体>500 mg/L	5篇^{[10, 15-16, 21, 26]}	0.0009	79%	随机	5.87(2.12~16.27)	<0.01
WBC>11×10⁹	4篇^{[10, 16-17, 21]}	0.16	41%	固定	8.26(4.50~15.13)	<0.01
CEA>10 mg/L	4篇^{[10, 16, 19, 21]}	0.02	69%	随机	0.83(0.39~1.77)	0.64
慢性阻塞性肺疾病	11篇^{[4, 6-10, 14, 16-17, 19, 21]}	0.35	10%	固定	1.51(1.16~1.95)	<0.01
糖尿病	15篇^{[4-7, 9-10, 13-14, 16-17, 19-21, 24, 27]}	0.97	0%	固定	1.16(0.89~1.51)	0.27
高血压	10篇^{[4-7, 9, 15, 17, 19, 27-28]}	0.98	0%	固定	0.98(0.75~1.30)	0.91
吸烟	17篇^{[4-8, 10-11, 14-17, 19-21, 23, 27-28]}	0.92	0%	固定	1.11(0.91~1.36)	0.29
饮酒	10篇^{[4, 10-11, 14, 16-17, 19-21, 23]}	0.82	0%	固定	1.24(0.94~1.62)	0.13
手术史	8篇^{[12, 14-15, 18-19, 23-24, 27]}	0.44	0%	固定	0.82(0.60~1.12)	0.22

相关指标	纳入研究数量	异质性检验		效应模型	Meta分析结果
相关指标	纳入研究数量	$P$ 值	$I 2$ 值	效应模型	$OR$ (95% $CI$ )	$P$ 值
化疗	13篇^{[4, 7, 10, 13-17, 19-21, 24, 26]}	0.06	40%	固定	2.69(2.08~3.47)	<0.01
深静脉置管	9篇^{[11-12, 14, 16, 19-21, 23, 27]}	0.02	57%	随机	2.66(1.68~4.19)	<0.01
白蛋白<30 g/L	3篇^{[10, 16-17]}	0.71	0%	固定	6.65(2.91~15.18)	<0.01
D二聚体>500 mg/L	5篇^{[10, 15-16, 21, 26]}	0.0009	79%	随机	5.87(2.12~16.27)	<0.01
WBC>11×10⁹	4篇^{[10, 16-17, 21]}	0.16	41%	固定	8.26(4.50~15.13)	<0.01
CEA>10 mg/L	4篇^{[10, 16, 19, 21]}	0.02	69%	随机	0.83(0.39~1.77)	0.64
慢性阻塞性肺疾病	11篇^{[4, 6-10, 14, 16-17, 19, 21]}	0.35	10%	固定	1.51(1.16~1.95)	<0.01
糖尿病	15篇^{[4-7, 9-10, 13-14, 16-17, 19-21, 24, 27]}	0.97	0%	固定	1.16(0.89~1.51)	0.27
高血压	10篇^{[4-7, 9, 15, 17, 19, 27-28]}	0.98	0%	固定	0.98(0.75~1.30)	0.91
吸烟	17篇^{[4-8, 10-11, 14-17, 19-21, 23, 27-28]}	0.92	0%	固定	1.11(0.91~1.36)	0.29
饮酒	10篇^{[4, 10-11, 14, 16-17, 19-21, 23]}	0.82	0%	固定	1.24(0.94~1.62)	0.13
手术史	8篇^{[12, 14-15, 18-19, 23-24, 27]}	0.44	0%	固定	0.82(0.60~1.12)	0.22

指标	Egger's test
指标	$t$ 值	$P$ 值
腺癌	1.39	0.179
肿瘤分期(Ⅲ~Ⅳ期)	0.84	0.412

指标	Egger's test
指标	$t$ 值	$P$ 值
腺癌	1.39	0.179
肿瘤分期(Ⅲ~Ⅳ期)	0.84	0.412

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