Clinical analysis of tumor and non-tumor patients complicated with pulmonary embolism

Abstract

Objective: To analyze the differences of the clinical characteristics and risk factors between tumor and non-tumor patients complicated with pulmonary embolism.

Methods: A retrospective analysis was conducted on 96 hospitalized patients complicated with pulmonary embolism admitted into 307 Hospital of PLA from January 2009 to December 2014. 96 cases were divided into tumor group (n=52) and non-tumor group (n=44) according to whether they were accompanied with malignant tumors. The relevant characteristics of tumor group, comparison of the risk factors and laboratory results between two groups were assessed.

Results: Lung cancer was prone to pulmonary embolism in malignant tumors and adenocarcinoma was the commonest pathological type. 31 (59.6%) cases developed pulmonary embolism within 3 months after tumor was diagnosed. The level of serum D-dimer and leukemia in tumor group were higher than that in non-tumor group (3241.06±4514.16 μg/L vs 1238.49±1236.69 μg/L and 9.68±5.53×10(9)/L vs 7.90±3.84×10(9)/L), with a significant statistical difference (P=0.004 and 0.015). The level of serum platlet in tumor group were lower than that in non-tumor group (204.63±132.58×10(9)/L vs 222.26±76.92×10(9)/L), with a significant statistical difference (P=0.023). Coronary heart disease, chronic lung disease, diabetes, hyperlipemia and cerebral infarction were significantly different between two groups (P<0.01). Unexplained dyspnea (51/96, 53.1%) was the main symptom of pulmonary embolism, yet no significant difference was found between the two groups. 33 cases (34.4%) combined with deep venous thrombosis of lower limb, right lower limb more than the left. Right main pulmonary artery and its branches embolism were seen in 46 cases (47.9%) according to imaging examination, and no significant difference between two groups. After thrombolytic and anticoagulant therapy, only 9 cases died of Pulmonary embolism.

Conclusion: There is no obvious and significant difference in clinical symptoms between tumor and non-tumor patients complicated with pulmonary embolism. Using of anticoagulant and thrombolytic therapy can obtain good curative effect upon diagnosis.

Keywords: D-dimer; Malignant tumor; pulmonary embolism.

Figure 1

A. Lung window shows left lung lesion; B and C. Mediastinal window shows left lung lesion and right main pulmonary artery thrombosis.

Figure 2

A. Right ventricular angiography showed obvious thickening of right inferior pulmonary artery, the lower part in the branch had a lot of white thrombus; B. Catheter into the right pulmonary artery and catheter thrombolytic (urokinase injection 30 wu); C. After 20 mins right pulmonary artery angiography showed artery branch white thrombus disappeared.